Papers by Ljubomir Panajotović
Vojnosanitetski Pregled, 2003
Vojnomedicinska akademija, Klinika za plasticnu hirurgiju i opekotine, Beograd Klju£ne reii koia,... more Vojnomedicinska akademija, Klinika za plasticnu hirurgiju i opekotine, Beograd Klju£ne reii koia, neoplazme; melanom; neoplazme, metastaze; hirurgija, operativne procedure; prognoza; prezivljavanje.
Journal of The European Academy of Dermatology and Venereology, Nov 1, 2007
1 Dissemond J, Körber A, Lehnen M, Grabbe S. Methicillin resistenter Staphylococcus aureus (MRSA)... more 1 Dissemond J, Körber A, Lehnen M, Grabbe S. Methicillin resistenter Staphylococcus aureus (MRSA) in chronischen Wunden: Therapeutische Optionen und Perspektiven. J Dtsch Dermatol Ges 2005; 3 : 256–262. 2 Schultz GS, Sibbald RG, Falanga V et al . Wound bed preparation: a systematic approach to wound management. Wound Repair Regen 2003; 1 : S1–S28. 3 Natarajan S, Williamson D, Grey J, Harding KG, Cooper RA. Healing of an MRSA-colonized, hydroxyurea-induced leg ulcera with honey. J Dermatolog Treat 2001; 12 : 33–36. 4 Dissemond J, Koppermann M, Esser S et al . Treatment of methicillin-resistant Staphylococcus aureus (MRSA) as part of biosurgical management of a chronic leg ulcer. Hautarzt 2002; 53 : 608–612. 5 O’Meara S, Cullum N, Majid M, Sheldon T. Systemic review of wound care management: (3) antimicrobial agents for chronic wounds; (4) diabetic foot ulceration. Health Technol Assess 2000; 4 : 1–237. 6 Dissemond J, Geisheimer M, Goos M. Eradikation eines ORSA bei einem Patienten mit Ulcus cruris durch Lavasept-Gel. ZfW 2004; 1 : 29–32.
Zdravstvena zaštita, 2011
Zdravstvena zaštita, 2015
Vojnosanitetski Pregled, 2003
PubMed, May 1, 1997
Fifty patients with pigmented villonodular synovitis (PVNS) were examined and treated in the Mili... more Fifty patients with pigmented villonodular synovitis (PVNS) were examined and treated in the Military Medical Academy in twenty-year period (1977-1996). Among them, 32 were male and 18 female (2:1), of average age from 6 to 72 years. Articular disease localization was 2.5 times more frequent compared to the non-articular. The rate of circumscribed in relation to diffuse form was 1.5:1. The ankle joint was most frequently involved (94%). In one patient, PVNS was proved in both ankle joints. The disease was clinically expressed as chronic, and 4 times more frequently as chronic recurrent synovitis. The data of previous injury were known in 14 patients. Associated rheumatic disease or injury was found in more than a half patients (53%). For the disease diagnosis there were used: physical examination, standard laboratory tests, radiography, ultrasonographic and magnet resonance examination and histopathologic examination of synovia obtained by open or arthroscopic biopsy. Surgical methods, such as total or partial synovectomy were applied in the therapy. Chemical synovectomy was performed in one patient, 6 months after the diagnostic arthroscopy due to disease recurrence. Therapeutic effect was estimated in 22 patients, from 3 months to 11 years after the surgery on the basis of disease recurrence. Except for the cited one patient, none other had the disease recurrence. It was concluded that timely diagnosis of PVNS offered more adequate treatment and conditions for complete recovery. In the disease limited just in the ankle joint, arthroscopic synovectomy would be the therapy of choice. In advanced diffuse form, total synovectomy should be performed for all the disease localizations.
Zdravstvena zaštita, 2011
Електричне повреде се догађају широм света и узрок су пет до десет одсто свих професионалних узро... more Електричне повреде се догађају широм света и узрок су пет до десет одсто свих професионалних узрока смрти. Лечење и рехабилитација повређених електричном струјом су дуготрајни, а само око 5,3% особа које су преживеле високоволтажне повреде (преко 1.000V) враћа се на ранији посао. Људски фактор (немар, непажња) јесте најчешћи повод ових несрећа. Нисковолтажне електроопекотине типично су изазване кућним апаратима, док су високоволтажне најчешће индустријски акциденти. Тежина овакве повреде зависи од волтаже, јачине, пута струје кроз организам, трајања контакта са извором и типа струјног кола (једносмерна или наизменична струја). Оне настају при директном контакту са извором струје високог напона или путем електричног лука, као и пламеном или блеском. Електроопекотина има централни карбонифицирани део у тачки контакта или уземљења. У клиничкој слици најдраматичније је стање апнеје, акутног застоја срца, парализе и губитка свести. Код високоволтажних повреда може бити неопходна кардиопулмонална реанимација. Промптна реанимација течностима је кључни поступак у превенцији реналне инсуфицијенције. Антиклостридијална профилакса и антибиотска терапија су обавезни. Ургентна есхаротомија и фасциотомија су често неопходни поступци у очувању виталности ектремитета. И поред Summary: Electrical injuries are happening around the world and they cause 5-10% of all occupational causes of death. Treatment and rehabilitation of injured by electric current are long lasting, and only about 5.3% of survivors of highvoltage injuries (more than 1.000V) returns to earlier work. The most common cause of these accidents is human factor. Low voltage electrical burns are typically caused by household appliances while most high-voltage are industrial accidents. Depending on the voltage, current, pathway, contact duration, and type of circuit (DC or AC current), can cause a variety of injuries.They resulting from direct contact with high voltage power source or by an electric arc and flame or flash. Electrical burns has a central carbonificated part on the of contact point or grounding. Clinical picture is dramatic state of sleep apnea, acute heart failure, paralysis and loss of consciousness. High voltage injury may require cardiopulmonary resuscitation. Prompt fluids resuscitation is a key process in the prevention of renal insufficiency. Antiklostridial prophylaxis and antibiotic therapy are required. Emergency fasciotomy and esharotomy are often necessary to preserve extremity vitality. Despite this a large percentage of amputations occurs. Surgical treatment involves early excision and tissue defects closure with plastic surgery reconstructive procedures.
Acta chirurgica Iugoslavica
During the microvascular transfer, the free flaps tissue is exposed to series of pathophysiologic... more During the microvascular transfer, the free flaps tissue is exposed to series of pathophysiological changes (tissue anoxia, tissue acidosis, anaerobic metabolism, wound healing and cicatrisation, degeneration of nerves fibers in the free flaps tissue, etc.) In 1993-1998 period, at the Clinic for Plastic Surgery and Burns at the Military Medical Academy, we analyzed histopathologic changes in the skin taken from the transferred flaps and from the recipient region surroundings of 31 patients with microvascular tissue transfer. The bioptic materials were taken between 6 and 36 months following the free tissue transfer--average 23.6 months. By light microscopy we analyzed histopathologic changes of the epidermis, collagen's fibers, skin adnexa, blood vessels and nerve fibers. The data obtained showed considerable difference in the histopathology test results of the epidermis, collagen's fibers, the skin adnex and the nerve fibers in the transferred free flaps compared to the res...
Vojnosanitetski pregled, 2003
Zdravstvena zastita, 2011
Електричне повреде се догађају широм света и узрок су пет до десет одсто свих професионалних узро... more Електричне повреде се догађају широм света и узрок су пет до десет одсто свих професионалних узрока смрти. Лечење и рехабилитација повређених електричном струјом су дуготрајни, а само око 5,3% особа које су преживеле високоволтажне повреде (преко 1.000V) враћа се на ранији посао. Људски фактор (немар, непажња) јесте најчешћи повод ових несрећа. Нисковолтажне електроопекотине типично су изазване кућним апаратима, док су високоволтажне најчешће индустријски акциденти. Тежина овакве повреде зависи од волтаже, јачине, пута струје кроз организам, трајања контакта са извором и типа струјног кола (једносмерна или наизменична струја). Оне настају при директном контакту са извором струје високог напона или путем електричног лука, као и пламеном или блеском. Електроопекотина има централни карбонифицирани део у тачки контакта или уземљења. У клиничкој слици најдраматичније је стање апнеје, акутног застоја срца, парализе и губитка свести. Код високоволтажних повреда може бити неопходна кардиопулмонална реанимација. Промптна реанимација течностима је кључни поступак у превенцији реналне инсуфицијенције. Антиклостридијална профилакса и антибиотска терапија су обавезни. Ургентна есхаротомија и фасциотомија су често неопходни поступци у очувању виталности ектремитета. И поред Summary: Electrical injuries are happening around the world and they cause 5-10% of all occupational causes of death. Treatment and rehabilitation of injured by electric current are long lasting, and only about 5.3% of survivors of highvoltage injuries (more than 1.000V) returns to earlier work. The most common cause of these accidents is human factor. Low voltage electrical burns are typically caused by household appliances while most high-voltage are industrial accidents. Depending on the voltage, current, pathway, contact duration, and type of circuit (DC or AC current), can cause a variety of injuries.They resulting from direct contact with high voltage power source or by an electric arc and flame or flash. Electrical burns has a central carbonificated part on the of contact point or grounding. Clinical picture is dramatic state of sleep apnea, acute heart failure, paralysis and loss of consciousness. High voltage injury may require cardiopulmonary resuscitation. Prompt fluids resuscitation is a key process in the prevention of renal insufficiency. Antiklostridial prophylaxis and antibiotic therapy are required. Emergency fasciotomy and esharotomy are often necessary to preserve extremity vitality. Despite this a large percentage of amputations occurs. Surgical treatment involves early excision and tissue defects closure with plastic surgery reconstructive procedures.
Zdravstvena zastita, 2011
Zdravstvena zastita, 2012
Инциденца меланома се удвостручује сваких 6-10 година и прима епидемијске размере. И у Србији је ... more Инциденца меланома се удвостручује сваких 6-10 година и прима епидемијске размере. И у Србији је евидентан стални пораст броја новооболелих од меланома. Меланом коже (МК) је малигнитет са мултифакторском етиологијом. Развој меланома је резултат интеракције између различитих фактора животне средине, генетских и конституционалних фактора. Излагање сунцу је једини еколошки фактор који је стално повезан са меланомом. Ризик од настанка меланома зависи од интеракције између начина излагања сунцу и од типа коже. Изложеност вештачким изворима УВ радијације (соларијум) даје негативне ефекте на кожи и њихова употреба може да повећа ризик од развоја МК. Између 5 и 12% људи има породичну историју меланома. Од четири изолована гена у породицама са меланомом највећи значај придаје се CDKN2A (p16). Као фактори ризика за настанак меланома могу се означити: а) фактори животне средине и професије, б) индивидуални фактори (конституционални, наследни, полни, старосни, делови тела) и в) комбинација више фактора. Спровођењем мера превенције може се значајно смањити ризик од развијања меланома. Примарна превенција има циљ смањење инциденце меланома, дејством на етиолошке факторе и факторе ризика, а секундарна рано препознавање, рану дијагнозу и почетак лечења меланома. Кључне речи: меланом коже, епидемиологија, фактори ризика, превенција. Summarу The incidence of melanoma is doubling every 6-10 years and receives epidemic proportions. In Serbia is evident a steady increase in the number of new cases of melanoma. Skin melanoma is a malignancy with multifactorial etiology. The development of melanoma is the result of interaction between various environmental factors, genetic and constitutional factors. Sun exposure is the only environmental factor that is always associated with melanoma. The risk of developing melanoma depends on the interaction between the type of sun exposure and the skin type. Exposure to artificial sources of UV radiation (solarium) gives a negative effect on the skin and it may increase the risk of melanoma. Between 5-12% of people have a family history of melanoma Of the four isolated genes in families with melanoma the CDKN2A (p16) is of the greatest importance. As risk factors for melanoma may be indicated: a) environmental factors, b) individual factors (constitutional, hereditary, sex, age, body parts and c) a combination of several factors. Implementation of preventive measures can significantly reduce the risk of developing melanoma. Primary prevention aims to reduce the incidence of melanoma, by influence of the etiology and risk factors, and secondary by early detection, diagnosis and treatment of melanoma.
Zdravstvena zastita, 2015
Zdravstvena zastita, 2014
Vojnosanitetski pregled. Military-medical and pharmaceutical review
Vojnosanitetski pregled, 2003
Bolesnici sa metastatskom diseminacijom bolesti imaju srednje prezivljavanje od oko 6 meseci. Bol... more Bolesnici sa metastatskom diseminacijom bolesti imaju srednje prezivljavanje od oko 6 meseci. Bolesnici sa malim brojem metastatskih lezija i produzenim intervalom bez bolesti mogu imati korist od hirurske ekscizije. Ukoliko je izvodljiva, hirurgija udaljenih metastaza ima znacaja u palijativnom smislu radi redukcije simptomatologije koju njihova pojava daje kao i radi poboljsanja kvaliteta i produzavanja zivota. Samo se operacijom metastaza, ukoliko je to izvodljivo, moze znacajno produziti zivot bolesnika sa metastatskim melanomom. Oko 25% bolesnika u IV klinickom stadijumu mogu biti kandidati za operaciju, bilo samu ili u sklopu kombinovanog lecenja koje ukljucuje jos i sistemsku imuno, biohemijsku i radijacijsku terapiju. Napredak u imunoterapiji, biohemioterapiji i radioterapiji nije doneo znacajnije poboljsanje u lecenju bolesnika sa metastatskim melanomom. Hirursko je, za sada, jedino standardno lecenje ovih bolesnika, dok se svi ostali modaliteti terapije primenjuju kroz kon...
Vojnosanitetski pregled, 2003
Free flaps are used in the surgical treatment of burns for wound closure where the burn is too de... more Free flaps are used in the surgical treatment of burns for wound closure where the burn is too deep, and in case, when after necrotic tissue excision, the bones, tendons, nerves, and blood vessels remain bare. Covering of the exposed structures is commonly performed in the primary delayed, or in the secondary wound treatment. The possibilities of covering the defects of the lower leg with local flaps are limited. Free flaps are used when all the possibilities of the other reconstructive procedures have been exhausted. The defect of the soft tissue of the lower leg was covered with free flaps in the injured soldiers with deep burns, treated at the Clinic for Plastic Surgery and Burns, Military Medical Academy, Belgrade. In one patient the wound closing was performed immediately after excision of necrotic tissues, and in the other two in the secondary management. The application of free microvascular flaps enabled the closure of large post excision defects of the lower leg in one oper...
Vojnosanitetski pregled, 2003
Background. War wounds caused by modern infantry weapons or explosive devices are very often asso... more Background. War wounds caused by modern infantry weapons or explosive devices are very often associated with the defects of soft and bone tissue. According to their structure, tissue defects can be simple or complex. In accordance with war surgical doctrine, at the Clinic for Plastic Surgery and Burns of the Military Medical Academy, free flaps were used in the treatment of 108 patients with large tissue defects. With the aim of closing war wounds, covering deep structures, or making the preconditions for reconstruction of deep structures, free flaps were applied in primary, delayed, or secondary term. The main criteria for using free flaps were general condition of the wounded, extent, location, and structure of tissue defects. The aim was also to point out the advantages and disadvantages of the application of free flaps in the treatment of war wounds. Methods. One hundred and eleven microvascular free flaps were applied, both simple and complex, for closing the war wounds with ex...
Vojnosanitetski pregled, 2003
Surgery is still the most effective treatment modality of skin melanoma. The margins of excision ... more Surgery is still the most effective treatment modality of skin melanoma. The margins of excision are determined by the thickness of primary tumor. From January 1999 to December 2001, 99 patients (57 male and 42 female, of the average age 55), were surgically treated at the Clinic for Plastic Surgery and Burns of the Military Medical Academy. The most usual localization of the primary tumor was the back (23.23%), followed by the forearm, and the lower leg. Regarding the clinical type of the melanoma, nodular melanoma dominated (62.62%). Microscopic staging of the melanoma (classification according to Clark and Breslow), showed that the majority of patients already suffered from the advanced primary disease, which called for radical excision and the choice of reconstructive methods in the closure of post-excision defects. The reconstructive plastic surgical methods enabled the closure of post-excision tissue defects, regardless of their size, structure, and localization. During the cl...
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Papers by Ljubomir Panajotović