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Savremena terapija infekcija podrazumeva zauzimanje zajedničkog stava/strategije o tome koji će se antimikrobni lekovi koristiti, pa se u skladu sa tim formira sopstveni lokalni vodič za primenu ovih lekova usklađen sa osetljivošću multirezistentnih (MDR) patogena prisutnih na različitim bolničkim odeljenjima. Za izradu lokalnog vodiča je neophodno prikupiti podatke o potrošnji i navikama propisivanja antimkrobnih lekova i o prevalenciji MDR patogena kao što su Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii i Escherichia coli. Izolati navedenih MDR patogena su praćeni na hirurškim (S) i internističkim (M) odeljenjima Kliničko-bolničkog centra „Dr Dragiša Mišović-Dedinje“ u periodu od 2012. do 2015. godine. Procena pravilnog propisivanja antimikrobnih lekova je zasnovana na metodologiji Global-Point Prevalence Survey koja je dizajnirana u Antverpu (Belgija). Procenat MDR patogena u odnosu na ukupan broj izolata K.pneumoniae - P.aeruginosa je značajno veći na S (86,2% i 49,1%) nego na M (63,2% i 36,9%) odeljenjima. Procenat MDR A.baumannii nije signifikantno različiti između S (93,7%) i M (79,5%) odeljenjima. U posmatranom periodu, postoji statistički značajan porast prevalencije MDR E.coli na S i M odeljenju (p<0,001). Ukupna potrošnja antibiotika (određena kao definisana dnevna doza na 100 bolesničkih postelja) za četiri godine je 369,7 i 261,5 na S i M odeljenjima, redom. Analizirano je ukupno 225 epizoda propisivanja antimikrobnih lekova u 138 lečenih odraslih pacijenata. Procenat propisivinja antimikrobnih lekova kao profilakse je 75% i 0%, na S i M odeljenjima, redom. Terapija je bila češće empirijska nego kauzalna (S, 86,8% i M, 80%). Procenat greške u propisivanju na S i M odeljenjima je bio 74,6% i 27,3%, redom. Indikatori kvaliteta, za propisivanje antimikrobnih lekova na S i M odeljenjima, su: neadekvatan izbor antimikrobnog leka (35,6% vs. 20,0%), neadekvatni dozni interval (70,6% vs. 16,9%) i dužina primene (72,5% vs. 23,1%), nedok, Contemporary antimicrobial therapy is based on unified decision/strategy about which antimicrobial drugs and how will be used, accordance to own guideline made on local proportion of multiple resistant drug isolates gathered on difference wards. In order to provide guidance data for clinically rational use of an antibiotics, consumption, prescribing and prevalence of multidrug resistant (MDR) Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii and Escherichia coli were monitored on the surgical (S) and medical (M) wards of the University Hospital Center „Dr. Dragiša Mišović-Dedinje“ (Belgrade, Serbia), in the study period from 2012. to 2015. Appropriateness of antimicrobial use was evaluatedusing the Global-Point Prevalence Survey method designed by the University of Antwerp. The percentages of MDR pathogens relative to the total number of isolates of K. pneumoniae and P. aeruginosa were higher on the S (86.2% and 49.1%) than on the M (63.2% and 36.9%) wards. The percentage of MDR A. baumannii was not different with statistical significance, between S (93.7%) and M (79.5%) wards. During the observed period, we recognize statistically significant increase in prevalence of MDR E.coli both on S and M wards. An overall antibiotics consumption (defined daily doses/100 beddays) during study was 369.7 and 261.5 on the S and M wards, respectively. A total of 225 prescriptions of antimicrobials were evaluated in138 adults admitted to wards. The percentage of antimicrobials prescribed for prophylaxis on the M and S wards were 0% and 75%, respectively. Therapies were more frequently empiric (S, 86.8% and M, 80%). The percentages of medical errors on the S and M wards were 74.6% and 27.3%, respectively. The quality indicators for antibiotic prescribing on the S and M wards were as follows: the incorrect choice of antimicrobials (35.6% vs. 20.0%), inappropriate dose interval (70.6% vs. 16.9%) or duration of therapy (72.5% vs. 23.1%), a nondocumented stop/revie

By applying of aconitictest in in vivo experiments in rats under deep anesthesia, there was investigated the antiarrhythmic potential of newly synthetized fluorinated derivatives of propafenone. The animals were divided into four experimental groups. The first (aconitine group) was treated with aconitine at a dose of 60 μg/kg, which led to pronounced cardiac rhythm disorder in a short period of time. The appearance of ventricular extrasystole (VES) was taken as a parameter for ascertainment of cardiac rhytm disorder. The remaining three animal groups were taken for testing the potential of propafenone and propafenone fluorinated derivatives to stop the arrhythmia, and which was induced by i.v. aconitine injection (60 μg/kg). Propafenone, as well as 50F derivative, did not convert the disturbed cardiac rhythm (survival of animals was 0%). By applying 5PF derivative in a dose of 6 mg/kg, the animals survived with occasional establishment of sinus rhythm., Primenom akonitinskog testa, u in vivo eksperimentima na pacovima u dubokoj anesteziji, ispitivan je antiaritmijski potencijal novosintetisanih fluoriranih derivata propafenona. Životinje su podeljene u četiri eksperimentalne grupe. Prva grupa (akonitinska grupa) je tretirana akonitinom u dozi od 60 μg/kg t.m., koja dovodi do vidnog poremećaja srčanog ritma u kratkom vremenskom periodu. Kao parameter za registrovanje poremećaja srčanog ritma uzetaje pojava ventrikularne ekstrasistole (VES). Ostale (tri) eksperimentalne grupe činile su životinje na kojima je ispitivan potencijal propafenona i fluoriranih derivata propafenona da zaustave aritmiju indukovanu i.v. injekcijom akonitina (60 μg/kg t.m.). Propafenon, kao i 50F derivat, nisu uspeli da konvertuju poremećen srčani ritam (preživljavanje životinja je 0 %). Prilikom aplikacije 5PF derivata u dozi od 6 mg/kg t.m. životinje su preživele, uz povremeno uspostavljanje sinusnog ritma.

The information on the inhibitory effect of propafenone in vascular smooth muscle is sparse. Propafenone acts through blockage of voltage-dependent cardiac Na+ channels, L-type Ca2+ channels, voltage-sensitive K+ (Kv) channels, as well as β-adrenergic receptors in the heart. The introduction of different chemical groups in the benzyl moiety of propafenone influences pharmacological properties of newly developed derivate of propafenone. Here we investigated the effect of new ortho-chloro derivate of propafenone (5OCl) on the vascular tone of precontracted rat aorta. 5OCl produced endothelium-independent relaxation of rat aorta. In order to test the involvement of different ion channels in 5OCl mechanism of action, antagonist of Na+, lidocaine, KV channels, 4-aminopyiridine (4-AP) and L-type Ca2+ channels, nifedipine were used. All tested antagonists of ion channels did not influence the relaxation of rat aorta induced by high a concentration of 5OCl (≥10 μM), but antagonized the relaxation induced by low concentrations of this propafenone derivate. Thus, 5OCl derivate has comparable potency and efficacy as propafenone. According to its interaction with lidocaine, 4-AP and nifedipine it seems that 5OCl partly shares the mechanism of action with propafenone. The mechanism of vasodilatation induced by high micromolar concentration of 5OCl is not defined and further investigations are necessary., Informacije o efektima propafenona na vaskularne glatke mišiće su oskudne. Propafenon blokira voltažno-zavisne Na+ kanale, Ca2+ kanale L-tipa, voltažno-senzitivne K+ (Kv) kanale i β-adrenergičke receptore u srcu. Uvođenje različitih hemijskih grupa u benzilni deo molekula propafenona utiče na promenu njegovih farmakoloških osobina. U ovoj studiji je ispitivan uticaj novog orto-hloro derivata (5OCl) propafenona na vaskularni tonus prekontrahovane aorte pacova. Orto hlorni derivat (5OCl) je izazvao endotel-nezavisnu relaksaciju aortnih prstenova. Da bi se ispitala uloga različitih jonskih kanala u ovoj relaksaciji, korišćeni su lidokain, (antagonist Na+ kanala), 4-aminopiridin (antagonist Kv kanala) i nifedipin (antagonist Ca2+ kanala L-tipa). Testirani antagonisti jonskih kanala nisu uticali na relaksaciju aorte pacova izazvanu visokom koncentracijom 5OCl (≥10 μM), ali su zato antagonizovali relaksaciju aorte koncentracijama 5OCl koje su bile manje od 10 μM. Prema tome, 5OCl derivat ima sličnu jačinu i efikasnost kao propafenon. Prema njegovoj interakciji sa lidokainom, 4-AP i nifedipinom može se reći da je mehanizam dejstva 5OCl sličan propafenonu. Mehanizam vazodilatacije 5OCl derivata u koncentracijama većim od 10 μM nije definisan i za to su potrebna dalja istraživanja.

Background: Laparoscopic surgery is widely recognized as a well-tolerated and effective method for cholecystectomy. It is also considered cost saving because it has been associated with a decreased hospital length of stay. Variables that might lead to increased costs in laparoscopic surgery are the technique and drugs used in anesthesia. Objective: The goal of this study was to compare the costs of 2 anesthetic techniques used in laparoscopic cholecystectomy (LC)-balanced versus IV anesthesia- from the standpoint of an outpatient surgical department, with a time horizon of 1 year. Methods: Patients scheduled to undergo elective LC were enrolled in this prospective case study. Patients were randomly allocated to receive balanced anesthesia, administered as low fresh gas flow (LFGF) with inhalational sevoflurane and IV sufentanil in a target controlled infusion (LFGF SS group), or IV anesthesia, administered as IV propofol/sufentanil in a target controlled infusion (TCI group). We used a microcosting procedure to measure health care resource utilization in individual patients to detect treatment differences. The costs of medications used for the induction and maintenance of anesthesia during surgery were considered for LFGF SS and TCI. Other end points included duration of anesthesia; mean times to early emergence, tracheal extubation, orientation, and postanesthesia discharge (PAD); pain intensity before first analgesia; number of analgesics required in the first 24 hours after surgery; and prevalences of nausea, vomiting, and agitation. Results: A total of 60 patients were included in this analysis (male/female ratios in the LFGF SS and TCI groups: 11/19 and 12/18, respectively; mean [SD] ages, 48 [7.9] and 47 [8.6] years; and mean [SD] body mass indexes, 26 [2.0] and 26 [3.0] kg/m(2)). The costs of anesthetics were significantly lower with LFGF SS compared with TCI (is an element of 17.40 [is an element of 2.66] vs is an element of 22.01 [is an element of 2.50] [20