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S Simic

Publications and source records attributed to S Simic.

18 recordsLinked to original sources
PubMed2001

Does tuberculosis after kidney transplantation follow the trend of tuberculosis in general population?

Despite improvement in graft survival, infection continues to be an important cause of morbidity and mortality after kidney transplantation. We analyzed the clinical courses and outcomes of 16 transplanted patients with positive cultures for mycobacterium tuberculosis. In the course of a 20 year period, there were 13 cases of tuberculosis registered that developed in 456 patients who underwent kidney transplantation in our department, and in three refugees transplanted in other centers (a prevalence of 3.13%). Five of them developed tuberculous infections during 1997. Five patients had residual tuberculosis in preoperative chest X-ray, and specific pyelonephritis as an underlying kidney disease in two of them. All patients with treated with triple immunosuppressives. Before tuberculosis onset, 14 patients experienced one or more episodes of acute rejection and were treated with steroid pulses, ALG or OKT3. Tuberculosis was diagnosed after a period of 1.5 months to 10 years after transplantation. At the time of an infection, the graft function was normal in eight patients and chronic graft failure was evident in eight patients (sCr 210-700 micromol/L). The infection was pulmonary in 12 patients; urinary in two; disseminated in two; pulmonary and urinary, pulmonary and intestinal, and pancytopenia in one patient. All patients were treated with rifampicin and isoniazid in addition to ethambutol for the first two-month period. Treatment lasted from 1-22 months. With 14 patients favorable microbiological responses were registered. Two patients died within the first six months (both with disseminated disease), and the mortality rate was 14.3%. Throughout the followup period, the graft function remained stable and normal in eight patients who had normal graft function at the time of infection onset. Although six patients recovered, progressive graft failure developed and hemodialysis was restarted in one patient two months after antituberculous therapy introduction, and in two patients three years later. Four patients died 2-14 months after AT therapy withdrawal. The causes of death were severe liver failure, cerebrovascular insult and CMV.

Adult↗
PubMed2001

Antimicrobial resistance of Streptococcus pneumoniae recovered from outpatients with respiratory tract infections in Germany from 1998 to 1999: results of a national surveillance study.

Clinically significant pneumococcal isolates were prospectively collected from outpatients with respiratory tract infections by 19 different clinical microbiology laboratories in Germany. Resistance rates in a total of 961 isolates were as follows: penicillin, 6.6%; clarithromycin, 10.6%; tetracycline, 13.9%; and levofloxacin, 0.1%. Among 324 isolates from children, pneumococcal serotypes 19F (17.0%), 23F (13.0%), and 6B (11.7%) were the predominant types.

Adolescent↗
PubMed2001

New strategies for polymer development in pharmaceutical science--a short review.

We are developing synthetic polymers for pharmaceutical and medical applications. These applications can be broadly grouped on how the polymer will be utilized e.g. material, excipient or molecule. Our focus is to develop polymers with more defined structures that are based on biological, physicochemical and/or materials criteria. Strategies are being developed to more efficiently optimize structure-property correlations during preclinical development. We describe two examples of our research on pharmaceutical polymer development: narrow molecular weight distribution (MWD) homopolymeric precursors which can be functionalized to give families of narrow MWD homo- and co-polymers, and hydrolytically degradable polymers.

Drug Industry↗
PubMed1999

The survey of healthcare software in Yugoslavia.

The aim of this study is to identify vendors of software packages applicable to health care system as well as to evaluate software packages offered to the health sector by a variety of sources, namely state owned software development companies, privately operated software development companies as well as sole traders. The approach undertaken was to preselect the potential suppliers via an initial targeted interview. Subsequently a questionnaire, consisting of 23 questions, was addressed to the selected vendors and suppliers. The response rate to the questionnaire was 58%. Investigation of 113 has revealed the non government software suppliers clearly lead in copyright ownership, IBM compatible personal computers were the platform of choice whereas majority of code was written utilising languages capable of supporting relational data base queries. The final outcome of the above study is a database of software packages and applications available to the health sector offering the health professionals and institutions guide lines and support in developing information systems, relevant subsystems and modules.

Cross-Sectional Studies↗
PubMed1999

Personal identifying number as a unique patient identifier in database on clinically treated patients in Belgrade: its use, advantages and drawbacks.

Database on clinically treated patients in Belgrade served as an example for analysis of possibilities for the use of Personal Identifying Number (PIN) as an Unique Patient Identifier. In the first part of the paper we analyzed filling up of the fields which contained data on PIN within complete databases in 1981, 1991 and 1996. Filling up of PIN was significantly changed in the three observed years: it was 18% in 1981; 68% in 1991, and 56% in 1996 respectively. Analysis of interactions among the chosen factors (type of hospital, demographic and social characteristics of patients, length of stay in hospital, manner of treatment, main diagnosis, treatment outcome) and measuring time, showed a different degree of statistical significance. In the second part of our paper we analyzed the unexpected decrease in filling up of PIN in 1996 (as compared to 1991) ussing the method of logistic regression, on 1% samples from the databases for the two respective years. On the basis of obtained models of filling up of UPI data, taken as dependent variable and the above factors (predictors) we analyzed the advantages and drawbacks of UPI application as an unique patient identifier.

Computer Communication Networks↗
PubMed1997

Management of hospital discharge data in Belgrade.

The paper presents a database on clinically treated patients in Belgrade, a computerized health-statistics information sub-system. It also analyses the organisation of report processing related to hospitalisation, types of indicators on hospital treatment (which are the result of such a processing) as well as their further utilisation on different levels of management within the system of health care in Belgrade.

Adolescent↗
PubMed1997

Developing mortality patterns: robust modified generalized likelihood ratio algorithm for infant mortality rate change detection.

A new robust modified generalized likelihood ratio algorithm, which enables the changes of mortality rates to be detected automatically, is applied. The procedure is based on the calculation of discrimination function using robust least squares estimates of AR mortality rates residuals. The feasibility of the approach is demonstrated with experimental data concerning infant mortality rate in Serbia.

Algorithms↗
PubMed1995

Nutritional effects of the siege on new-born babies in Sarajevo.

OBJECTIVE: To investigate the influence of maternal nutrition on perinatal mortality, morbidity, malformations and low birth weight (< 2500 grams). DESIGN: All mothers and their babies born in Kosevo Hospital during three different time periods were sampled: September 1992 to February 1993 (pilot study), May 1993 to February 1994 (main study) and statistics compiled in 1991 (pre-war). SETTING: Data were collected at the gynaecology and obstetric clinic, Kosevo hospital, city of Sarajevo. SUBJECTS: A total of 920 babies were included in the pilot study, 1225 mothers of 1237 babies participated in the main study and birth data from 8676 babies born in 1991 were used as baseline data. INTERVENTIONS: Birth outcome data were compiled for all three time periods. In the main study, a questionnaire was administered on arrival at the clinic in which mothers were asked to estimate their weight prior to pregnancy. Information on energy and protein intake was collected for all women by estimating weekly food intake during pregnancy. Mothers were weighed and had their heights measured within 12 hours of delivery. Women were divided into three groups based on their body mass index (BMI) using self-reported prepregnancy weight (underweight BMI < 21.5; normal weight BMI 21.5-25.6; overweight BMI > 25.6). Four groups were defined according to dietary intake during pregnancy (daily energy intake < 2755 kcal and 2755 + kcal; protein intake < 80 and 80 + grams). RESULTS: Weight gain during pregnancy was low in overweight women (3.2 kg) compared with normal weight (10.4 kg) and underweight (11.7 kg) women. Underweight women had babies with the lowest mean birthweight (3072 grams) and the highest percentage of low birth weight babies (13.0%). Perinatal mortality increased from 15.8/1000 live births in 1991 (pre-war) to 36/1000 in May 1993-February 1994. Morbidity among babies increased from 3.4% to 8.2% in the same time period. There was a significant increase in babies born with malformations from 0.4% in the pre-war period to 3.0% in May 1993 to February 1994. CONCLUSIONS: It is concluded that the war has had a deleterious effect on birth outcomes in Sarajevo.

Birth Weight↗
PubMed1991

Evaluation of the epidemiology of hepatitis B virus cross-infection in a maternity hospital.

OBJECTIVE: To determine the hepatitis B infection risk in a university hospital of obstetrics and gynecology. SETTING: The University Hospital of Obstetrics and Gynecology, The University of Sarajevo, Yugoslavia. DESIGN: Staff members were divided into three groups: 73 doctors, 184 medical technicians working in delivery rooms, and 55 medical technicians working with postnatal care. The patients were 63 women, aged 17 to 39 years (mean = 26.11 years), pregnant for the first time and in the first stage of labor. Participants all had a negative history of hepatitis B and no known contact with the hepatitis B virus. RESULTS: The incidence of hepatitis B infections among physicians, technicians, and postnatal care technicians was 1.36%, 3.8%, and 3.6%, respectively. The incidence among patients was 4.76%. The daily infection risk varied between 1% and 17% of all deliveries. CONCLUSIONS: The risks of transmission of the hepatitis B virus to hospital workers in this setting is indeed high enough to make a case for hepatitis B vaccination in susceptible staff members. Even if vaccination of staff members is carried out, hygienic measures to prevent the transmission of bloodborne infection between patients and from patients to staff are of the utmost importance.

Adolescent↗