TY  - JOUR
AU  - Stefanović, Zvezdan
AU  - Donfrid, Branislav
AU  - Jovanović, Tomislav
AU  - Zorić, Zoran D.
AU  - Radojević-Popović, Radmila
AU  - Zoranović, Uroš
PY  - 2020
UR  - https://smile.stomf.bg.ac.rs/handle/123456789/2504
AB  - Background/Aim. Diabetic foot is the term for the pathological changes on foot in patients with diabetes. It is caused by diabetic angiopathy, polyneuropathy and osteoarthropathy. The treatment is complex and long-term and often leads to the loss of the extremity. The appliance of hyperbaric oxygen therapy (HBOT) has a lot more important place in adjuvant treatment of this disease. The aim of this study was to determine the influence of HBOT on the wound healing in comparison with the conventional treatment, the possibility of shortening the time of the treatment in patients with diabetic foot. Methods. In a five-year period a retrospective-prospective multicentric study, involving 60 patients with diabetic foot divided into two groups, was performed. The first group (group A) consisted of 30 patients treated by combined therapy (with medications, surgical therapy and HBOT). All the patients were receiving HBOT in the Special Hospital for Hyperbaric Medicine, CHM Hollywell-Neopren in Belgrade. The control group (group B) also consisted of 30 patients treated with medications and surgical therapy, but without HBOT. Results. The demographic data, the types of diabetes, as well as the Wagner classification stage of diabetic ulcers and radiography scans of changes in bones were equal in both groups. The median healing time of the Wagner grade III ulcer in the group A was 37.36 days [mean +/- standard deviation (SD) = 65.6 +/- 45.8 days], and in the group B 99.78 days (mean +/- SD = 134.8 +/- 105.96 days) and it was statistically significant (p = 0.074). The median time of recovery in patients of the group A with the Wagner grade IV was 48.18 days (mean +/- SD = 49.7 +/- 33.8 days), and in the group B 85.05 days (mean +/- SD = 86.7 +/- 71.6 days) and that was statistically significant (p = 0.121). The foot amputations were performed in both groups in 3 (10%) patients. In the group A there were no high amputations, whereas in the group B there were 4 (13.33%) below-knee amputations and 4 (13.33%) above-knee amputations which was highly statistically significant (p  lt  0.0001). Conclusion. In this study, HBOT definitely showed positive adjuvant role in the treatment of diabetic foot. For the good treatment result it is essential the timely and successful surgical treatment of the ulcer and the use of bandage with the healing dressings. In case of the clear signs of local infection, the antibiotic therapy according to the antibiogram is necessary.
PB  - Vojnomedicinska akademija - Institut za naučne informacije, Beograd
T2  - Vojnosanitetski pregled
T1  - Hyperbaric oxygenation in prevention of amputations of diabetic foot
VL  - 77
IS  - 4
SP  - 363
EP  - 372
DO  - 10.2298/VSP180220081S
ER  - 

@article{
author = "Stefanović, Zvezdan and Donfrid, Branislav and Jovanović, Tomislav and Zorić, Zoran D. and Radojević-Popović, Radmila and Zoranović, Uroš",
year = "2020",
abstract = "Background/Aim. Diabetic foot is the term for the pathological changes on foot in patients with diabetes. It is caused by diabetic angiopathy, polyneuropathy and osteoarthropathy. The treatment is complex and long-term and often leads to the loss of the extremity. The appliance of hyperbaric oxygen therapy (HBOT) has a lot more important place in adjuvant treatment of this disease. The aim of this study was to determine the influence of HBOT on the wound healing in comparison with the conventional treatment, the possibility of shortening the time of the treatment in patients with diabetic foot. Methods. In a five-year period a retrospective-prospective multicentric study, involving 60 patients with diabetic foot divided into two groups, was performed. The first group (group A) consisted of 30 patients treated by combined therapy (with medications, surgical therapy and HBOT). All the patients were receiving HBOT in the Special Hospital for Hyperbaric Medicine, CHM Hollywell-Neopren in Belgrade. The control group (group B) also consisted of 30 patients treated with medications and surgical therapy, but without HBOT. Results. The demographic data, the types of diabetes, as well as the Wagner classification stage of diabetic ulcers and radiography scans of changes in bones were equal in both groups. The median healing time of the Wagner grade III ulcer in the group A was 37.36 days [mean +/- standard deviation (SD) = 65.6 +/- 45.8 days], and in the group B 99.78 days (mean +/- SD = 134.8 +/- 105.96 days) and it was statistically significant (p = 0.074). The median time of recovery in patients of the group A with the Wagner grade IV was 48.18 days (mean +/- SD = 49.7 +/- 33.8 days), and in the group B 85.05 days (mean +/- SD = 86.7 +/- 71.6 days) and that was statistically significant (p = 0.121). The foot amputations were performed in both groups in 3 (10%) patients. In the group A there were no high amputations, whereas in the group B there were 4 (13.33%) below-knee amputations and 4 (13.33%) above-knee amputations which was highly statistically significant (p  lt  0.0001). Conclusion. In this study, HBOT definitely showed positive adjuvant role in the treatment of diabetic foot. For the good treatment result it is essential the timely and successful surgical treatment of the ulcer and the use of bandage with the healing dressings. In case of the clear signs of local infection, the antibiotic therapy according to the antibiogram is necessary.",
publisher = "Vojnomedicinska akademija - Institut za naučne informacije, Beograd",
journal = "Vojnosanitetski pregled",
title = "Hyperbaric oxygenation in prevention of amputations of diabetic foot",
volume = "77",
number = "4",
pages = "363-372",
doi = "10.2298/VSP180220081S"
}

Stefanović, Z., Donfrid, B., Jovanović, T., Zorić, Z. D., Radojević-Popović, R.,& Zoranović, U.. (2020). Hyperbaric oxygenation in prevention of amputations of diabetic foot. in Vojnosanitetski pregled
Vojnomedicinska akademija - Institut za naučne informacije, Beograd., 77(4), 363-372.
https://doi.org/10.2298/VSP180220081S

Stefanović Z, Donfrid B, Jovanović T, Zorić ZD, Radojević-Popović R, Zoranović U. Hyperbaric oxygenation in prevention of amputations of diabetic foot. in Vojnosanitetski pregled. 2020;77(4):363-372.
doi:10.2298/VSP180220081S .

Stefanović, Zvezdan, Donfrid, Branislav, Jovanović, Tomislav, Zorić, Zoran D., Radojević-Popović, Radmila, Zoranović, Uroš, "Hyperbaric oxygenation in prevention of amputations of diabetic foot" in Vojnosanitetski pregled, 77, no. 4 (2020):363-372,
https://doi.org/10.2298/VSP180220081S . .

TY  - JOUR
AU  - Donfrid, Branislav
AU  - Lozanče, Olivera B.
AU  - Stefanović, Zvezdan
AU  - Janković, Aleksandar N.
AU  - Dimković, Nada
PY  - 2018
UR  - https://smile.stomf.bg.ac.rs/handle/123456789/2344
AB  - Introduction The autologous radio-cephalic arteriovenous fistula (AVF) is the best vascular access for patients on chronic hemodialysis. In some patients with inadequate blood vessels, it is necessary to create proximal AVF, or arteriovenous grafts. High percentage of primary graft failure is noted in cases where diameters of the brachial artery and the basilic vein are insufficient. The aim of this work was to introduce a new surgical technique for arteriovenous creation in patients with inadequate blood diameter. Case outline The authors have proposed implantation of brachio-basilic polytetrafluoroethylene AV forearm loop graft in two acts. In the first act, the native brachio-basilic AVF was created in the distal region of the arm by side-to-end anastomosis. Three to four weeks after the first act, significant dilatation of brachial artery and basilic vein was noted (confirmed by the use of color duplex sonography technique). During the second act, polytetrafluourethylene graft was implanted by end-to-end anastomosis on the dilated basilica vein. Conclusion AV graft that was created in two acts has sufficient blood flow without early or late complications. Primary patency was 30 months and secondary patency was 50 months. As an original method in the current literature, we recommend it in different clinical settings when there are no better alternatives for vascular access.
AB  - Uvod Autologna radiocefalična arteriovenska fistula je najbolji vaskularni pristup za bolesnike na hemodijalizi. Kod nekih bolesnika sa neadekvatnim krvnim sudovima potrebno je kreirati proksimalnu arteriovensku fistulu ili implantirati arteriovenski graft. Visoki procenat ranog zatajivanja grafta najčešće nastaje usled malog prečnika bazilične vene ili brahijalne arterije. Cilj ovoga rada je bio da prikaže novu hiruršku tehniku za kreiranje arteriovenskog grafta kod bolesnika sa neodgovarajućim dijametrom krvnih sudova. Prikaz bolesnika Urađena je implantacija PTFE grafta u vidu petlje na podlaktici u dva akta. U prvom aktu je u distalnom delu nadlaktice kreirana brahio-bazilična latero-terminalna arteriovenska fistula pod uglom od 90 stepeni. Posle četiri nedelje, kontrolnom doplersonografijom je konstatovano znatno povećanje prečnika bazilične vene i brahijalne arterije. U drugom aktu je bazilična vena poprečno presečena i sa dve temino-terminalne anastomoze u vidu petlje umetnut PTFE graft. Zaključak Ovako kreiran arteriovenski graft u dva akta davao je zadovoljavajući protok krvi bez komplikacija. Primarna funkcionalnost je iznosila 30 meseci, a sekundarna 50 meseci. U dostupnoj literaturi ovakav postupak nije objavljen, a preporučujemo ga kod bolesnika bez drugih mogućnosti za kreiranje vaskularnog pristupa.
PB  - Srpsko lekarsko društvo, Beograd
T2  - Srpski arhiv za celokupno lekarstvo
T1  - Two-stage forearm brachio-basilic loop arteriovenous graft for hemodialysis
T1  - Podlakatni brahio-bazilični arteriovenski graft za hemodijalizu u dva akta
VL  - 146
IS  - 5-6
SP  - 316
EP  - 319
DO  - 10.2298/SARH161228138D
ER  - 

@article{
author = "Donfrid, Branislav and Lozanče, Olivera B. and Stefanović, Zvezdan and Janković, Aleksandar N. and Dimković, Nada",
year = "2018",
abstract = "Introduction The autologous radio-cephalic arteriovenous fistula (AVF) is the best vascular access for patients on chronic hemodialysis. In some patients with inadequate blood vessels, it is necessary to create proximal AVF, or arteriovenous grafts. High percentage of primary graft failure is noted in cases where diameters of the brachial artery and the basilic vein are insufficient. The aim of this work was to introduce a new surgical technique for arteriovenous creation in patients with inadequate blood diameter. Case outline The authors have proposed implantation of brachio-basilic polytetrafluoroethylene AV forearm loop graft in two acts. In the first act, the native brachio-basilic AVF was created in the distal region of the arm by side-to-end anastomosis. Three to four weeks after the first act, significant dilatation of brachial artery and basilic vein was noted (confirmed by the use of color duplex sonography technique). During the second act, polytetrafluourethylene graft was implanted by end-to-end anastomosis on the dilated basilica vein. Conclusion AV graft that was created in two acts has sufficient blood flow without early or late complications. Primary patency was 30 months and secondary patency was 50 months. As an original method in the current literature, we recommend it in different clinical settings when there are no better alternatives for vascular access., Uvod Autologna radiocefalična arteriovenska fistula je najbolji vaskularni pristup za bolesnike na hemodijalizi. Kod nekih bolesnika sa neadekvatnim krvnim sudovima potrebno je kreirati proksimalnu arteriovensku fistulu ili implantirati arteriovenski graft. Visoki procenat ranog zatajivanja grafta najčešće nastaje usled malog prečnika bazilične vene ili brahijalne arterije. Cilj ovoga rada je bio da prikaže novu hiruršku tehniku za kreiranje arteriovenskog grafta kod bolesnika sa neodgovarajućim dijametrom krvnih sudova. Prikaz bolesnika Urađena je implantacija PTFE grafta u vidu petlje na podlaktici u dva akta. U prvom aktu je u distalnom delu nadlaktice kreirana brahio-bazilična latero-terminalna arteriovenska fistula pod uglom od 90 stepeni. Posle četiri nedelje, kontrolnom doplersonografijom je konstatovano znatno povećanje prečnika bazilične vene i brahijalne arterije. U drugom aktu je bazilična vena poprečno presečena i sa dve temino-terminalne anastomoze u vidu petlje umetnut PTFE graft. Zaključak Ovako kreiran arteriovenski graft u dva akta davao je zadovoljavajući protok krvi bez komplikacija. Primarna funkcionalnost je iznosila 30 meseci, a sekundarna 50 meseci. U dostupnoj literaturi ovakav postupak nije objavljen, a preporučujemo ga kod bolesnika bez drugih mogućnosti za kreiranje vaskularnog pristupa.",
publisher = "Srpsko lekarsko društvo, Beograd",
journal = "Srpski arhiv za celokupno lekarstvo",
title = "Two-stage forearm brachio-basilic loop arteriovenous graft for hemodialysis, Podlakatni brahio-bazilični arteriovenski graft za hemodijalizu u dva akta",
volume = "146",
number = "5-6",
pages = "316-319",
doi = "10.2298/SARH161228138D"
}

Donfrid, B., Lozanče, O. B., Stefanović, Z., Janković, A. N.,& Dimković, N.. (2018). Two-stage forearm brachio-basilic loop arteriovenous graft for hemodialysis. in Srpski arhiv za celokupno lekarstvo
Srpsko lekarsko društvo, Beograd., 146(5-6), 316-319.
https://doi.org/10.2298/SARH161228138D

Donfrid B, Lozanče OB, Stefanović Z, Janković AN, Dimković N. Two-stage forearm brachio-basilic loop arteriovenous graft for hemodialysis. in Srpski arhiv za celokupno lekarstvo. 2018;146(5-6):316-319.
doi:10.2298/SARH161228138D .

Donfrid, Branislav, Lozanče, Olivera B., Stefanović, Zvezdan, Janković, Aleksandar N., Dimković, Nada, "Two-stage forearm brachio-basilic loop arteriovenous graft for hemodialysis" in Srpski arhiv za celokupno lekarstvo, 146, no. 5-6 (2018):316-319,
https://doi.org/10.2298/SARH161228138D . .

TY  - JOUR
AU  - Marinković, Violeta M.
AU  - Stefanović, Zvezdan
AU  - Zorić, Zoran D.
AU  - Donfrid, Branislav
PY  - 2017
UR  - https://smile.stomf.bg.ac.rs/handle/123456789/2209
AB  - Diseases of veins are considered one of the most common diseases of modern man, right after caries of teeth. Those diseases usually come to exist as a result of genetic and/or other pre-dispositioning factors, however, in most cases, those factors can be effectively tamed through preventive and therapeutic methods. Two studies were carried out on randomly selected third and fourth year stomatology college students. In the first study, we solely focused on the effects of monotherapy compression stockings. The second study was a continuation of the first and the respondents were asked to take venotonic Diosmin (Detralex 1000 mg) in addition to wearing compression stockings. In the group of 30 patients, 49% had positive family history of the disease, and in total, 70% showed signs of discomfort and diseases related to venous system. Ten respondents who showed major problems or pathological changes, were given custom made Sigvaris graduated compression stockings, which they wore for eight weeks. Final results of the first study showed that the feeling of heaviness in the legs reduced in 55.55% of respondents, while 66.66% patients recorded reduced pain in legs when standing for a long time. Issues of swelling of the bottom of the feet and lower legs disappeared for all patients. In the second study, which included adding a dose of Diosmin in addition to compression stockings, 66.66% of the patients saw signs of heaviness feeling in the legs improve, 77.77% recorded that pain in the legs when standing for a long time decreased and 100% of patients saw swelling of the bottom of the feet and lower legs disappear. This eight week study was too short to show significant signs of improvement in varicose, however, we expect that in six months, patients will begin to show signs of improvement in varicose altered veins. When comparing the results of the first and second study, we concluded that the three-month combination therapy of compression stockings and Diosmin yielded 12.5% better results of reduction of the following symptoms: feeling of heaviness in the legs, pain in the legs when standing for a long time, then when just using the compression socks (study 1).
AB  - Oboljenja vena spadaju u najučestalije bolesti savremenog čoveka,odmah posle kariesa zuba. Na njihov nastanak utiču nasledni i stečeni faktori. Stečeni fatori rizika najčešće su okidač za aktiviranje naslednih faltora (predispozicije) na koje se može efikasno delovati, kako preventivno tako i terapijski. U Hirurškoj klinici KBC Zvezdara, nastavnoj bazi Stomatološkog fakulteta Univerziteta u Beogradu, sprovedene su dve studije na studentima IV i V godine slučajnim izborom ispitanika. U prvoj studiji su opservirani efekti monoterapije kompresivnim čarapama na tok oboljenja vena, druga studija je nastavak prve i ispitanici su pored kompresivnih čarapa uzimali i venotonik Diosmin (Detralex 1000 mg). U grupi od 30 ispitanika znake oboljenja vezane za venski sistem pokazalo je 70% ispitanika, a pozitivnu porodičnu anamnezu je imalo 49% ispitanika. Deset ispitanika je imalo značajne tegobe ili patološke promene koje su zahtevale neku terapiju i dobili su graduisane kompresivne čarape po meri firme Sigvaris, koje su nosili 8 nedelja. Završni rezultati prve studije pokazali su da je poboljšanje osećaja težine u nogama osetilo 55,55% ispitanika, smanjenje bolova u nogama pri dužem stajanju zabeleženo je kod 66,66% ispitanika, otoke stopala i potkolenica nije imao više nijedan ispitanik (smanjenje tegoba 100%) U drugoj studiji, u kojoj je pored kompresivnih čarapa bio uključen i venotonik nakon osam nedeljne primene kombinovane terapije poboljšanje simptoma osećaja težine u nogama osetilo je 66,66% ispitanika, bolove kod dužeg stajanja 77,77%, dok se i u ovoj studiji pokazalo da otoke stopala i potkolenica na kraju studije nije imao nijedan ispitanik (100% poboljšanje). Za povlačenje varikoziteta je studija bila suviše kratka ali posle 6 meci je za očekivati i poboljšanje stanja varikozno izmenjenih vena. Komparacijom rezultata prve i druge studije došli smo do zaključka da je tromesečna kombinovana terapija kompresivnim čarapama i venotonikom dala bolje rezultate za 12,5% u smanjenju simptoma osećaja težine u nogama i bolova u nogama pri dužem stajanju u odnosu na monoterapiju samo kompresivnim sredstvima.
PB  - Savez inženjera i tehničara Srbije, Beograd
T2  - Tehnika
T1  - Direct correlation between compression stockings and venotonics (Diosmins) and flow vein diseases in stomatology students
T1  - Uticaj graduisanih kompresivnih čarapa i venotonika (Diosmina) na tok oboljenja vena kod studenata stomatologije
VL  - 72
IS  - 2
SP  - 297
EP  - 302
DO  - 10.5937/tehnika1702297M
ER  - 

@article{
author = "Marinković, Violeta M. and Stefanović, Zvezdan and Zorić, Zoran D. and Donfrid, Branislav",
year = "2017",
abstract = "Diseases of veins are considered one of the most common diseases of modern man, right after caries of teeth. Those diseases usually come to exist as a result of genetic and/or other pre-dispositioning factors, however, in most cases, those factors can be effectively tamed through preventive and therapeutic methods. Two studies were carried out on randomly selected third and fourth year stomatology college students. In the first study, we solely focused on the effects of monotherapy compression stockings. The second study was a continuation of the first and the respondents were asked to take venotonic Diosmin (Detralex 1000 mg) in addition to wearing compression stockings. In the group of 30 patients, 49% had positive family history of the disease, and in total, 70% showed signs of discomfort and diseases related to venous system. Ten respondents who showed major problems or pathological changes, were given custom made Sigvaris graduated compression stockings, which they wore for eight weeks. Final results of the first study showed that the feeling of heaviness in the legs reduced in 55.55% of respondents, while 66.66% patients recorded reduced pain in legs when standing for a long time. Issues of swelling of the bottom of the feet and lower legs disappeared for all patients. In the second study, which included adding a dose of Diosmin in addition to compression stockings, 66.66% of the patients saw signs of heaviness feeling in the legs improve, 77.77% recorded that pain in the legs when standing for a long time decreased and 100% of patients saw swelling of the bottom of the feet and lower legs disappear. This eight week study was too short to show significant signs of improvement in varicose, however, we expect that in six months, patients will begin to show signs of improvement in varicose altered veins. When comparing the results of the first and second study, we concluded that the three-month combination therapy of compression stockings and Diosmin yielded 12.5% better results of reduction of the following symptoms: feeling of heaviness in the legs, pain in the legs when standing for a long time, then when just using the compression socks (study 1)., Oboljenja vena spadaju u najučestalije bolesti savremenog čoveka,odmah posle kariesa zuba. Na njihov nastanak utiču nasledni i stečeni faktori. Stečeni fatori rizika najčešće su okidač za aktiviranje naslednih faltora (predispozicije) na koje se može efikasno delovati, kako preventivno tako i terapijski. U Hirurškoj klinici KBC Zvezdara, nastavnoj bazi Stomatološkog fakulteta Univerziteta u Beogradu, sprovedene su dve studije na studentima IV i V godine slučajnim izborom ispitanika. U prvoj studiji su opservirani efekti monoterapije kompresivnim čarapama na tok oboljenja vena, druga studija je nastavak prve i ispitanici su pored kompresivnih čarapa uzimali i venotonik Diosmin (Detralex 1000 mg). U grupi od 30 ispitanika znake oboljenja vezane za venski sistem pokazalo je 70% ispitanika, a pozitivnu porodičnu anamnezu je imalo 49% ispitanika. Deset ispitanika je imalo značajne tegobe ili patološke promene koje su zahtevale neku terapiju i dobili su graduisane kompresivne čarape po meri firme Sigvaris, koje su nosili 8 nedelja. Završni rezultati prve studije pokazali su da je poboljšanje osećaja težine u nogama osetilo 55,55% ispitanika, smanjenje bolova u nogama pri dužem stajanju zabeleženo je kod 66,66% ispitanika, otoke stopala i potkolenica nije imao više nijedan ispitanik (smanjenje tegoba 100%) U drugoj studiji, u kojoj je pored kompresivnih čarapa bio uključen i venotonik nakon osam nedeljne primene kombinovane terapije poboljšanje simptoma osećaja težine u nogama osetilo je 66,66% ispitanika, bolove kod dužeg stajanja 77,77%, dok se i u ovoj studiji pokazalo da otoke stopala i potkolenica na kraju studije nije imao nijedan ispitanik (100% poboljšanje). Za povlačenje varikoziteta je studija bila suviše kratka ali posle 6 meci je za očekivati i poboljšanje stanja varikozno izmenjenih vena. Komparacijom rezultata prve i druge studije došli smo do zaključka da je tromesečna kombinovana terapija kompresivnim čarapama i venotonikom dala bolje rezultate za 12,5% u smanjenju simptoma osećaja težine u nogama i bolova u nogama pri dužem stajanju u odnosu na monoterapiju samo kompresivnim sredstvima.",
publisher = "Savez inženjera i tehničara Srbije, Beograd",
journal = "Tehnika",
title = "Direct correlation between compression stockings and venotonics (Diosmins) and flow vein diseases in stomatology students, Uticaj graduisanih kompresivnih čarapa i venotonika (Diosmina) na tok oboljenja vena kod studenata stomatologije",
volume = "72",
number = "2",
pages = "297-302",
doi = "10.5937/tehnika1702297M"
}

Marinković, V. M., Stefanović, Z., Zorić, Z. D.,& Donfrid, B.. (2017). Direct correlation between compression stockings and venotonics (Diosmins) and flow vein diseases in stomatology students. in Tehnika
Savez inženjera i tehničara Srbije, Beograd., 72(2), 297-302.
https://doi.org/10.5937/tehnika1702297M

Marinković VM, Stefanović Z, Zorić ZD, Donfrid B. Direct correlation between compression stockings and venotonics (Diosmins) and flow vein diseases in stomatology students. in Tehnika. 2017;72(2):297-302.
doi:10.5937/tehnika1702297M .

Marinković, Violeta M., Stefanović, Zvezdan, Zorić, Zoran D., Donfrid, Branislav, "Direct correlation between compression stockings and venotonics (Diosmins) and flow vein diseases in stomatology students" in Tehnika, 72, no. 2 (2017):297-302,
https://doi.org/10.5937/tehnika1702297M . .