bluuebunny/crossref_metadata_2025 huggingface dataset:
Priporočila za telesno dejavnost nosečnic
Authors: Videmšek Mateja , Bokal Vrtačnik Eda , Šćepanović Darija , Žgur Lidija , Videmšek Naja , Meško Maja , Karpljuk Damir , Štihec Jože , Hadžić Vedran
Published: November 2017

Properly selected and prescribed physical activity during pregnancy has a favorable effects on the health of pregnant women and the fetus, and is excellent preparation for childbirth. Absolute and relative contraindications to exercise during pregnancy are well defined, as well as the warning signs to terminate exercise while pregnant. Knowledge of these is essential for physically active pregnant women and exercise professionals that work with pregnant women. Pregnant women should be moderately physically active every day of the week for at least 30 minutes. The term moderate is thoroughly and clearly defined in the guidelines. Resistance exercises during pregnancy are safe but it is advised to use light loads and a large number of repetitions (e.g. 15-20 repetitions). Strength exercises for the pelvic floor muscles deserves a special place during pregnancy. Appropriate forms of physical activity for pregnant women are walking and jogging, swimming and aquatic exercise, cycling, Pilates and yoga, aerobics, fitness and cross-country skiing. Certain forms of physical activity need special adjustments (alpine skiing, ice skating and rollerblading, racket sports, team ball games, horseback riding and scuba diving).
O astrologiji krvnih skupin - zakaj krvne skupine AB0 ne določajo človekovega značaja niti njegove prehrane
Authors: Gajšek Grbec Martina , Pfeifer Marija , Rožman Primož
Published: November 2017

AB0 blood groups are inherited markers on blood cells. Since their discovery, there were numerous attempts to be attributed a wide variety of biological functions they don’t possess. The purpose of this article is primarily to inform the professional, as well as lay public that the theory of healthy nutrition based on AB0 blood groups represents nothing more than a pseudoscience used for mass exploitation and commercial purposes. ABO blood groups were attributed such characteristics by naturopathic doctor Peter D'Adamo, who on the basis of false methods and erroneous assumptions wrote a bestseller "Eat Right For Your Type". It claims that the blood groupsAB0 represent a "key to the functioning of our immune system" and that the blood group based diet represents a “key to the health of every man”. As in the case of nutrition based on the ABO blood groups, the scientific knowledge in the field of immunohematology is misused to mislead the lay public, we are obliged to explain the real meaning and the role of blood groups in health and disease, the misuse of blood groups in relation to healthy nutrition.
Presaditev trebušne slinavke
Authors: Kovač Damjan , Tomažič Aleš , Tomažič Marjeta
Published: November 2017

The transplantation of the pancreas replaces endocrine function of the pancreas, establish normoglycemia, prevents the progression of chronic diabetic complications and prolongs patients life. The most common indication for transplantation is type 1 diabetes with renal failure, in which the transplantation of both organs is performed simultaneously (around 72% of all transplants) or transplantation of the pancreas in patient that already had a kidney transplant. In recent years pancreas is transplanted also in selected patients with type 2 diabetes mellitus (about 7% of the transplants). Pancreas only transplant performed before renal failure is due to narrow indications very rare procedure. Possible complications of transplantation are pancreatic vein or artery thrombosis, intra-abdominal infections, pancreatitis, pancreatic pseudocyst or fistula resulting in the 25-50% of re-laparatomy. With modern immunosuppression, the survival of pancreas transplant markedly improved; 5 year survival in simultaneous kidney and pancreas is around 70%. Even taking into account the possible complications, most authors agree that the simultaneous transplantation of the pancreas and kidney in addition to prolonging life expectancy also significantly improves the quality of patients life.
Slovenski nacionalni register bolnikov s primarno imunsko pomanjkljivostjo
Authors: Blazina Stefan , Markelj Gašper , Debeljak Maruša , Koren Jeverica Anja , Toplak Nataša , Bratanič Nevenka , Pokorn Marko , Kopač Peter , Pikelj Pečnik Andreja , Košnik Mitja , Jazbec Janez , Kuhar Marijana , Ihan Alojz , Avčin Tadej
Published: November 2017

Data from Slovene national primary immunodeficiency (PID) registry are presented. Besides clinical and genetic data of patients with PID, quality indicators in patient care are included. Data are systematically collected in Department of Allergology, Rheumatology and Clinical Immunology in collaboration with physicians of different specialities. Increasing number and spectrum of PID are recognised in Slovenia. After establishment of Slovene multidisciplinary group in PID care in 2007 thorough immunological and genetic diagnostics, subcutaneous immunoglobulin replacement and treatment of PID with haematopoietic stem cell transplantation were introduced in routine clinical practice in Slovenia. Increased medium age of PID patients reflects improved survival and better recognition of PID in adults. According to the data in comparable registries percentages of patients with predominantly antibody deficiencies and complement deficiencies are low and high, respectively.
AKUTNI IDIOPATSKI EDEM SKROTUMA – PRIKAZ PRIMERA
Authors: Kuščer Anja , Roškar Zdravko
Published: November 2017

Acute idiopathic scrotal edema is a rare cause of acute scrotum that runs a benign course and resolves without sequelae. It is characterised by acute swelling and erythema of the scrotum. Color Doppler imaging typically demonstrates the “fountain sign” that, in the presence of normal testes and epididymis, additionally confirms the diagnosis.In this paper, we review the characteristics of acute idiopathic scrotal edema and report a clinical case.
Kirurško zdravljenje raka pljuč z razširjeno levo pnevmonektomijo in resekcijo dela prsne aorte pri bolnici z masivno hemoptizo – Prikaz primera
Authors: Greif Boris , Klokočovnik Tomislav , Štupnik Tomaž
Published: November 2017

Severe airway bleeding or massive hemoptysis is a rare condition that carries high mortality. Patients are at  risk of life-thretening respiratory compromise due to the airways  filling with blood. The main principles in the management of massive hemoptysis are:  maintainance of airway patency, localization of the source of bleeding and control of the hemorrhage. Most cases of massive hemoptysis are caused by inflammatory lung diseases such as aspergiloma, tuberculosis and bronchiectasis while a severe bleeding from a malignant lung tumor is a rare find.We present a case of massive hemoptysis in a 60-year old woman, caused by the invasion of lung cancer into the left pulmonary trunk and aorta, which was successfully managed by an extended left pneumonectomy, with the resection of the proximal part of the descending thoracic aorta and interposition of a vascualar graft without extra corporeal circulation. A complete (R0) resection was also achieved.
Plesni v notranjem okolju in možni učinki na zdravje
Authors: Perčič Simona , Otorepec Peter , Kukec Andreja
Published: November 2017

Moulds are multicellular fungi that are ubiquitous in indoor and outdoor environment. Exposure to moulds can occur through inhalation, ingestion, and touching mouldy surfaces. Adverse health effects may occur through allergic, infectious, irritant, and toxic processes. In our review we elucidated some possible harmful mechanisms of moulds on the health of the population and some preventive recommendation. A systematic literature review was carried out in two bibliographic databases, Science Direct and PubMed, in the period from 1985 to February 2015. We systematically observed also the internet pages from CDC (Centers for Diseases Control and Prevention) and EPA (Environmental Protection Agency). Out of websites we accepted the roles for recommendation in case of moulds indoor buildings. Epidemiological studies all over the world have shown associated mould sensitivity, with the development, persistence and severity of asthma and other respiratory allergic diseases. Recent studies suggest that host immune response to environmental moulds and genetic factors may play an important role in the development of allergic respiratory diseases. This new knowledge could help us to prevent and cure these diseases. There are also studies about the potential toxic reactions to the micotoxins. The prevention of developing moulds in indoor environment is still the most important for the well-being of all population.
Zunajcelični membranski vezikli v transfuzijskih proizvodih-biologija in klinična pomembnost
Authors: Krstova Krajnc Emilija , Jež Mojca , Rožman Primož
Published: November 2017

Extracellular membrane vesicles are fragments shed from plasma membranes off all cell types that are undergoing apoptosis or are being subjected to various types of stimulation or stress.  Even in the process of programmed cell death (apoptosis), cell fall apart of varying size vesicles. They expose phosphatidylserine (PS) on the outer leaflet of their membrane, and bear surface membrane antigens reflecting their cellular origin. Extracellular membrane vesicles have been isolated from many types of biological fluids, including serum, cerebrospinal fluid, urine, saliva, tears and conditioned culture medium. Flow cytometry is one of the many different methodological approaches that have been used to analyze EMVs. The method attempts to characterize the EMVs cellular origin, size, population, number, and structure. EMVs are present and accumulate in blood products (erythrocytes, platelets) as well as in fresh frozen plasma during storage. The aim of this review is to highlight the importance of extracellular vesicles as a cell-to-cell communication system and the role in the pathogenesis of different diseases. Special emphasis will be given to the implication of extracellular membrane vesicles in blood products and their clinical relevance. Although our understanding of the role of  EMVs in disease is far from comprehensive, they display promise as biomarkers for different diseases in the future and also as a marker of quality and safety in the quality control of blood products.
Celiakija – spoznavanje bolezni v svetu in pri Slovencih
Authors: Glišović Maša , Mršnik Marina , Zupanič Slavec Zvonka
Published: November 2017

Coeliac disease is a multisystem disease that occurs as a result of the hypersensitivity of human organism to gluten, which is a protein found in the grain of wheat, barley, rice and oats. The disease was first described in the 2nd century; however, it is still often a great mystery. The pathophysiology of the disease was explained by the researchers after the Second World War, the final confirmation of the hypothesis, however, occurred in 1952. In the next few years the researchers have discovered many different antibodies in the blood of the patients and demonstrated that the disease is due to the immune response of the body to gluten. In the nineties they focused on the detection of the antigen and managed to discover it in the 1997. It was the enzyme tissue transglutaminase. The discovery of the main antigen has led also to improved diagnosis, besides the histological diagnosis based on the biopsy of the intestinal mucosa they also used ELISA test for determining antibodies against tissue transglutaminase. This review article presents the discovery of the disease in children and adults worldwide and in Slovenia and also the research work of the Slovenian doctors especially in the central Slovenian clinics, which led to public recognition of the disease and formation of societies for patients. Coeliac disease still remains an object of great interest and brings new answers to open questions.
Življenje ogrožajoč angioedem po zaviralcu angiotenzinove konvertaze: prikaz dveh primerov Life-threatening angioedema induced by angiotensin-converting enzyme inhibitor: two case reports
Authors: Rupnik Erik , Kariž Stojan , Iglič Črtomir , Zidarn Mihaela
Published: November 2017

Background. Angioedema is a rare but potentially very serious complication of treatment with angiotensin converting enzyme inhibitors (ACEI). Angioedema is due to the accumulation of bradykinin, because angiotensin converting enzyme is the key enzyme for its degradation.Case reports. We present two patients with life-threatening angioedema while taking ACEI. Both patients had already had episodes of angioedema. Angioedema didn't respond to adrenaline. In both patients intubation was difficult.Conclusion. In the acute phase of angioedema due to ACEI it is necessary to protect the airways. Bradykinin receptor inhibitors shorten the duration of episodes of angioedema. In the long term it is essential to permanently avoid ACEI.
Zastrupitve z gama-hidroksibutiratom v Ljubljani med letoma 2000 in 2014
Authors: Škafar Mojca , Grenc Damjan , Koželj Gordana , Brvar Miran
Published: November 2017

Background: Gamma-hydroxybutyrate (GHB) is an illicit drug causing unconsciousness and respiratory depression. The aim of this study was to evaluate the clinical presentation and treatment in patients admitted to the University Medical Centre Ljubljana (UMCL).Methods: In this study we included all retrospectively reviewed cases of GHB-poisoning admitted to the UMCL between 2000 and 2014. We collected all the data regarding the overdose circumstances, clinical presentation, treatment and toxicological analysis of blood and urine.Results: In the previous 15 years a total of 74 patients were admitted to the UMCL due to GHB-poisoning. The first case of GHB-poisoning was observed in 2002 and the numbers have largely increased since 2012. 86% of all the patients ingested the drug intentionally, 82% were male and the median age of admitted patients was 27 years. We recorded 6 mass GHB-poisonings in which 2-4 patients were admitted simultaneously. The most common presenting symptom of GHB-poisoning was diminished level of consciousness (95%), with 53% being unresponsive to pain. Vomiting (30%), bradycardia (28%), hypotension (26%), hypoventilation with respiratory insufficiency (19%) and agittation upon awakening (31%) were common as well. Concomitant alcohol and illicit drug use was recorded in 61% of cases. 80% of all the patients were treated symptomatically, 14% were mechanically ventilated.Conclusions: The incidence of GHB-poisoning has increased in recent years. GHB-poisoned patients are predominantly male, often admitted in groups, who ingest the drug intentionally at parties during weekends. The most common presenting symptom of GHB-poisoning is unconsciousness. Treatment is symptomatic.
MOTENA GIBLJIVOST GLASILK - etiologija in simptomi
Authors: Pintarić Karlo , Hočevar Boltežar Irena
Published: November 2017

Paresis or paralysis of one or both vocal cords affects some significant aspects of a human life: breathing, swallowing and speech. The major causes for reduced mobility or even immobility are innervation damage, less often fixation of vocal cord or impaired mobility of crycoarytenoid joint. An injury of the superior or/and inferior laryngeal nerve can be a consequence of different medical procedures, tumor growth, trauma, infection, neurological disorders, radiation exposure, toxic damage, impaired circulation of the area or it is idiopathic. The symptoms are different in the case of unilateral and bilateral paresis of the vocal folds. They also depend on the cause for the impaired mobility. In the patients with unilateral vocal fold paresis, hoarseness and aspiration during swallowing are the leading symptoms. In the bilateral vocal fold paralysis, dyspnea prevails.
Klinično vodenje transfuzije - sodobni pristopi za optimizacijo transfuzije
Authors: Poženel Primož , Zver Samo , Nikolić Božidar , Rožman Primož
Published: November 2017

As a precious biological substance, donated blood has to be used in a sustainable, safe and efficient manner. Therefore good transfusion practice in modern surgery, anaesthesiology and intensive care is of key importance.  New therapeutic methods, operations, transplantation of organs and hematopoietic stem cells often require intensive and long term supportive therapy including transfusions of blood components. Nowadays, transfusion service is confronted with continuously increasing demand for sufficient quantity of safe high quality blood, and on the other hand with limited resources of blood.  The article deals with the current modern approaches for optimization of transfusion practice and Patient Blood Management that have to be implemented  in Slovenian hospitals.
FARMAKOLOGIJA KANABINOIDOV
Authors: Ferjan Ilonka , Kržan Mojca , Lipnik-Štangelj Metoda , Žiberna Lovro , Stanovnik Lovro , Černe Katarina
Published: November 2017

The discovery of cannabinoid receptors and endocannabinoid system has led to the potential therapeutic use of cannabis derivatives. Cannabinoids acting through the CB1 receptors modulate the release of other neurotransmitters in central nervous system, whereas the activation of peripheral CB2 receptors results in decreased inflammatory response and increased apoptosis of some tumor cells populations. The cannabinoids have been authorized for chemotherapy-induced nausea and vomiting; stimulation of appetite; to alleviate neuropathic pain and spasticity in multiple sclerosis, and to reduce pain in cancer patients. Efficacy in other diseases and clinical conditions should be proven in ongoing or future clinical trials. Isolation and identification of different cannabinoids from cannabis and synthesis of novel, more selective, derivatives widens their therapeutic potential. However, there are numerous adverse effects reported, especially when cannabinoids formulations with unknown quantitative and qualitative composition are used. Addiction, tolerance, withdrawal symptoms, increased risk of acute myocardial re-infarction, and increased risk of psychosis or worsening of psychosis are the most common adverse effects of cannabinoids. Acute adverse effects e. g. severe central nervous system depression, are more pronounced in children than in adults. Potential cannabinoid medicines should be subject to the same regulations as other potential drugs. Safety and efficacy of any potential drug candidate, regardless whether it is plant-derived or synthesized, should be proven in non-clinical studies and clinical trials, as well as the marketing authorization must be issued by the appropriate drug authority. Patients deserve a quality manufactured product, which always contains the specified amount of "Remedium cardinale."
Opis lastnosti in funkcij samopoškodovalnega vedenja brez samomorilnega namena in njegova povezava s hlepenjem, impulzivnostjo in anksioznostjo pri slovenskih mladostnikih
Authors: Bunderla Teja , Gregorič Kumperščak Hojka
Published: November 2017

Background: the aim of this study was the description of the properties and functions of nonsuicidal self-injury (NSSI) diagnosed with DSM-V. This is a first study of this kind on a selected sample of Slovene adolescents. Moreover, it was our intention to define the level of anxiety, traumatization and impulsivity. We tried to test the hypothesis of the importance of craving on NSSI maintenance.Methods: the clinical trial was carried out on a final sample of 29 13–19 year old Slovene adolescents. All participants completed the translated self-rating questionnaires: ISAS, STAI, BIS-11, ETISR-SF and SICQ. A descriptive overlook of the results was made, as well as a comparison with the reference literature and a correlation analysis of quantitative variables.Results: the average age at the beginning of NSSI was 12.32 (SD= 1.84) years.18 adolescents were ranked as very impulsive. 25 were traumatized (of which 9 were sexually abused). We proved moderate positive correlations between the number of lifetime NSSI acts and craving (r=0.420, p=0.023), between the S-anxiety and impulsivity (r=0.381, p=0.041), T-anxiety and impulsivity (r=0.432, p=0.019) and a moderate negative correlation between the age of first NSSI and the lifetime number of NSSI acts (r= -0.385, p=0.043).Conclusions: specificities of the Slovene sample of adolescents with NSSI are the young age at the beginning of NSSI, NSSI predominantly in solitude and a high percentage of sexually abused adolescents. The last is especially important in the treatment of adolescents on every level of healthcare. The number of NSSI acts was in a positive correlation with the craving. Impulsivity of adolescents with NSSI was in a positive correlation with the anxiety. Both claims should be replicated on a bigger sample and a causality relationship among entities should be evaluated.
Hiponatremična hipokloremična dehidracija pri otrocih s cistično fibrozo v Sloveniji; pogostost in priporočila za preprečevanje in zdravljenje
Authors: Praprotnik Marina , Kalan Gorazd , Bratina Nataša , Vidmar Ivan , Aldeco Malena , Lepej Dušanka , Krivec Uroš
Published: November 2017

Background: Young children and rarely adolescents with cystic fibrosis can develop hyponatremic hypochloremic dehydration with metabolic alkalosis. The purpose of this article was to review the incidence of this metabolic disorder in our CF patients.Methods: We investigated the medical records of all children diagnosed with cystic fibrosis who are under follow-up in the CF center at the University Childrenʹs Hospital Ljubljana, and were hospitalised or treated on an outpatient basis due to hyponatremic, hypochloremic dehydration in the period from 2007–2012. Data analysis included clinical and laboratory findings.Results: A total of 4 children (7.2 %) from Ljubljana CF center (55 patients under the age of 19 years) were enrolled in the study. We observed 5 episodes of hyponatremic hypochloremic dehydration in 4 patients (one boy had two episodes). All were homozigous for ΔF 508 mutation. Two had episodes in summer and two in autumn, so that no season prevalence of its occurence was found. Median age at admission to the hospital due to hyponatremic hypochloremic dehydration was 7 months (range 4–34). One boy had a hypovolemic shock at the time of admission to the hospital.Conclusions: The results of our study show that dehydration with hypoelectrolytaemia is a rare complication in children with CF in Slovenia, but due to the severity of clinical signs it is an important disorder. Vomiting and fatigue are the warning signs that should alert parents and physicians to consider the possibility of this complication which can be prevented by proper hydration and salt replacement. If left untreated, it can cause seizures, arrhythmias and even death.
Non-invasive prenatal cell-free fetal DNA testing for down syndrome and other chromosomal abnormalities
Authors: Strah Darija , Ovniček Petra , Bernik Janez
Published: November 2017

Background: Chorionic villus sampling and amniocentesis as definitive diagnostic procedures represent a gold standard for prenatal diagnosis of chromosomal abnormalities. The methods are invasive and lead to a miscarriage and fetal loss in approximately 0.5–1 %. Non-invasive prenatal DNA testing (NIPT) is based on the analysis of cell-free fetal DNA from maternal blood. It represents a highly accurate screening test for detecting the most common fetal chromosomal abnormalities. In our study we present the results of NIPT testing in the Diagnostic Center Strah, Slovenia, over the last 3 years.Methods: In our study, 123 pregnant women from 11th to 18th week of pregnancy were included. All of them had First trimester assessment of risk for trisomy 21, done before NIPT testing.Results: 5 of total 6 high-risk NIPT cases (including 3 cases of Down syndrome and 2 cases of Klinefelter’s syndrome) were confirmed by fetal karyotyping. One case–Edwards syndrome was false positive. Patau syndrome, triple X syndrome or Turner syndrome were not observed in any of the cases. Furthermore, there were no false negative cases reported. In general, NIPT testing had 100 % sensitivity (95 % confidence interval: 46.29 %–100.00 %) and 98.95 % specificity (95 % confidence interval: 93.44 %–99.95 %). In determining Down syndrome alone, specificity (95 % confidence interval: 95.25 %- 100.00 %) and sensitivity (95 % confidence interval: 31.00 %–100.00 %) turned out to be 100 %. In 2015, the average turnaround time for analysis was 8.3 days from the day when the sample was taken. Repeated blood sampling was required in 2 cases (redraw rate = 1.6 %).Conclusions: Our results confirm that NIPT represents a fast, safe and highly accurate advanced screening test for most common chromosomal abnormalities. In current clinical practice, NIPT would significantly decrease the number of unnecessary invasive procedures and the rate of fetal loss caused by invasive diagnostics.
Catheter ablation of repetitive ventricular tachycardia in patients with ischemic heart disease – our experience
Authors: Šinkovec Matjaž , Pernat Andrej , Antolič Bor , Klemen Luka
Published: November 2017

Ventricular tachycardia (VT) poses a significant risk for sudden death and heart failure exacerbation in patients with ischemic heart disease. Catheter-based radiofrequency ablation is the last treatment option for patients with frequent VT recurrences despite antiarrhythmic drugs. The aim was to present our retrospective catheter ablation data in this group of patients.The majority of 34 patients, who underwent percutaneous endocardial radiofrequency catheter ablation, were male, median age 67.5 years, who presented with electrical storm, had underlying cardiomyopathy after remote inferior wall myocardial infarction and preceding myocardial revascularization procedure, and had been implanted with cardioverter-defibrillator (ICD). Two ablation methods were used: linear ablation and/or scar homogenization. Acute ablation success (non-inducibility of any VT) was achieved in 59 % of procedures. VT could not be interrupted in 2 (6 %) patients. Pericardial tamponade that needed surgical intervention occurred in one procedure (2 %), and was related to inadvertent perforation of the right ventricular apex with a diagnostic catheter. Seven (20 %) patients died and additional 3 were lost from the median of 31 (6–151, rank) months of follow-up. No late VT recurrences were demonstrated in 20 (59 %) patients, and rare in 4 (12 %). Overall, the ablation procedure was successful in 71 % of patients.Catheter ablation gave very good long-term clinical result in about two-thirds of our patients with ischaemic cardiomyopathy and frequent VT recurrences. Catheter ablation, preferably with scar homogenization approach, should be considered early to reduce the number of VT episodes and ICD discharges.
Avstro-ogrska vojaška saniteta – razstave ob 100-letnici začetka soške fronte
Authors: Velnar Tomaž , Kovačič Simon , Pipan David , Valantič Egon
Published: November 2017

This year, the centennial anniversary of the Isonzo Front outbreak is being remembered. Among many exhibitions to commemorate the beginning of the greatest conflict in the Slovenian territory, a photography collection of the Austro-Hungarian military medicine was presented in the Faculty of Medicine and the University Medical Centre Ljubljana. In words and pictures, the accents of the medical activities of that time were described.
Medikamentozno zdravljenje endometrioze: pregled stanja in nove možnosti zdravljenja
Authors: Jakič Maja , Vogler Andrej , Lanišnik Rižner Tea
Published: November 2017

Endometriosis is a gynecological disease that is defined as the presence of endometrium-like tissue outside the uterine cavity, and it is one of the main causes of female infertility. Although there is unfortunately no known ‘optimal’ treatment for endometriosis, there are three treatment options: medication, surgical treatment, and a combination of both. The gold standard for diagnosis of endometriosis is a diagnostic laparoscopy, which is also therapeutic. Indications for pharmacological treatment of endometriosis include empirical treatment for patients with pelvic pain who are normal on gynecological examination, or who have recurrent disease after surgical treatment or in combination with surgical treatment. In everyday practice, non-steroid anti-inflammatory drugs, oral contraceptives, and progestins per os are used as first-line pharmacological treatments of endometriosis. Gonadoliberin agonists can be used as second-line treatment, although their use is discouraged. These medications can be used alone or in combination. Studies over the last 10 years have shown that many other agents have potential for treatment of endometriosis. These can be broadly classified into several groups: anti-inflammatory agents, and agents that interfere with the hormonal system, or with other pathophysiological processes, such as a disturbed immune system, reduced apoptosis, enhanced angiogenesis, degradation of the extracellular matrix, increased oxidative stress, and epigenetic changes. However, their introduction into routine use requires more convincing clinical studies to confirm their effectiveness.
ELEKTROKEMOTERAPIJA – UČINKOVITA METODA ZDRAVLJENJA TUMORJEV S KOMBINACIJO KEMOTERAPEVTIKA IN ELEKTRIČNEGA POLJA
Authors: Stepišnik Tina , Jarm Tomaž , Grošelj Aleš , Edhemović Ibrahim , Djokić Mihajlo , Ivanecz Arpad , Trotovšek Blaž , Brecelj Erik , Potrč Stojan , Čemažar Maja , Glumac Nebojša , Pečnik Tjaša , Veberič Biserka , Gadžijev Eldar , Strojan Primož , Snoj Marko , Miklavčič Damijan , Serša Gregor
Published: November 2017

Electrochemotherapy is a local treatment for skin tumors and also deep seated tumors and metastases. Electrochemotherapy is based on enhanced cytotoxic effectiveness of bleomycin or cisplatin by electroporation, which increases drug delivery into cells in tumors. Electrochemotherapy is an ablative technique of high effectiveness with over 80% objective responses of electrochemotherapy treated tumors. Its advantage is the simplicity of the procedure that can be utilized in treatment of different tumor histiotypes. Currently it is predominantly used in palliative intent when the other treatment options have been exhausted. For the translation of electrochemotherapy into the clinics also the technological development that is now focusing into the treatment of deep-seated tumors was important. In Slovenia we are at the forefront in the treatment of liver tumors and head and neck tumors, while the others are developing electrochemotherapy for treatment of bone and brain metastases as well as endoluminal tumors.
Ali vemo kaj je dobra klinična smernica?
Authors: Gersak Ksenija , Fras Zlatko , Rems Miran
Published: November 2017

Clinical guideline is systematically developed set of statements and assist a doctor, other health care practitioners and patients to make decisions about appropriate health care for specific clinical circumstances.They are produced under the auspices of medical specialty associations, relevant professional societies and organizations.The guidelines are developed by standards; they are based on a systematic review of the scientific evidence, statements are explicitly linked to the supporting evidence and graded according to the strength of that evidence.
Psihološki vidiki enkopreze brez organskega izvora
Authors: Košir Vesna , Janjušević Peter
Published: November 2017

Encopresis is defined as a voluntary or involuntary passage of stool in inappropriate places, causing soiling of clothes by a child aged four years or above whenbowelcontrolcannormally be expected. It affects 1 to 3% of paediatric population. This article focuses on retentive encopresis that is related to chronic constipation and overflow incontinence. Absence of bowel control has an important impact on physical health, psychosocial functioning and family life. Personal and contextual predisposing, precipitating, maintaining and protective factors for encopresis in a context of etiological hypotheses are discussed.Most children with encopresis have no physical problems to explain the disorder. Text is focusingon chronic constipation, chaotic family environment, parent-child interaction, developmental delay, and avoidance of defecation, the role of family, stressors and anxiety over toileting. Common causes of encopresis include a low fibre diet, lack of hydration, little or no exercise and premature toilet training.There is comorbidity with cognitive delays, learning disabilities, attention deficit disorder, conduct or oppositional disorders. In treatment the most effective outcome is shown cases where medical and psychological treatment programmes are used in conjoint manner. The main components are psychoeducation, clearing the faecal mass with laxative use and bowel retraining with toileting, accident management, diet and exercise. In cases, where children don't recognise when they are about to defecate, biofeedback may be a useful adjunct. With effective strategies encopresis can be eliminated, but relapses may occur.
Metformin: od mehanizmov delovanja do napredne klinične uporabe
Authors: Janić Miodrag , Volčanšek Špela , Lunder Mojca , Janež Andrej
Published: November 2017

Metformin represents the first line of treatment and is the most widely prescribed antihypergycemic drug in type 2 diabetic patients. It can be used as monotherapy or in combination with other oral antihyperglycemic drugs or insulin. Additionally, it is also prescribed in type 1 diabetic patients, it proved to be eﬀective in prediabetes and also provided beneficial eﬀects in other insulin resistant states, for example in polycystic ovary syndrome. Nevertheless, the exact molecular mechanism of its action remains unknown. It was shown that it inhibits liver gluconeogenesis, facilitates glucose uptake into peripheral tissues, such as striated muscle; it also acts in the gut. Besides antihyperglycemic eﬀects, metformin was also shown to possess several beneficial, protective eﬀects, so-called pleiotropic eﬀects: particularly on the cardiovascular system and in cancer patients. Metformin has only few side eﬀects, the most serious being metformin-associated lactic acidosis. The latter appears in rare clinical cases with pre-existing chronic kidney disease or advanced heart failure with tissue hypoperfusion, which consequently represent relative contraindications for metformin use. In the past, metformin treatment was usually discontinued when performing iodine contrast imaging, however recently there is evidence of its safety even in patients with higher stages of chronic kidney disease. All in all, metformin is a drug with a long tradition and a promising future.
Rib anomalies – a case and an overview of the literature.
Authors: Kocijančič Igor , Zupan Andraž , Slak Peter
Published: November 2017

Anatomic rib variants (numeric and structural) are reported to occur in less than 2 % of the general population and are rarely of any clinical significance. Frequently noticed developmental rib anomalies include fused and bifid ribs, cervical ribs and rib dysplasia. Occasionally they can cause problems when interpreting chest radiographs, therefore it is important for radiologists to be familiar with them and consider rib variants in diﬀerential diagnosis.The following case report presents an 88-year old female with a left bifid intrathoracic rib.
Collagenous gastritis: a case report
Authors: Malgaj Marija , Zidar Nina , Sever Nejc
Published: November 2017

Background: Collagenous gastritis is a rare disease defined histologically by the subepithelial deposition of collagen bands thicker than 10 μm and the infiltration of inflammatory mononuclear cells in the lamina propria. There are approximately 60 reported cases of collagenous gastritis in the English literature. Case report: We present a 41-year-old female patient with weight loss, postprandial abdominal discomfort, early satiety, flatulence and a change in bowel habits. Her current laboratory investigation reports showed mild sideropenic anemia. Esophagogastroduodenoscopy and corresponding histological examination showed findings, typical for collagenous gastritis. Gastric emptying scintigraphy and SPECT/CT of abdomen revealed gastroparesis.Conclusion: Collagenous gastritis is a diagnostically challenging disease and its exact etiology remains unclear. Even though collagenous gastritis is a histologic diagnosis, the combination of other key clinical and endoscopic findings should prompt consideration of this entity. No safe and effective treatment has been established. Therefore, better understanding of the disease and study of a larger number of patients will help to establish diagnostic criteria and therapeutic strategies.
PREPOZNAVA IN ZDRAVLJENJE SOLZNEGA OČESA
Authors: Olup Brigita Drnovšek , Beltram Matej , Hawlina Gregor
Published: November 2017

Background: Watering eye is in the population a very common eye phenomenon. Watering eye is presented with excessive amount of tears on the surface of the eye that are spilled over the edge of the eyelid on the skin of the eyelids and face. Basically, watering eye is divided into excessive tearing or lacrimation and on the lack of drainage of tears or epiphora. Only correct identification of both phenomena can lead to successful treatment of several patients.Methods: The article presents the anatomy and physiology of lacrimal system causes for lacrimation and epiphora, diagnostic tests and types of treatment. Laser treatment method for epiphora which is performed at the Eye Hospital in Ljubljana is presented.Results: The most common cause for epiphora is nasolacrimal duct occlusion, which is treated by dacryocystorhinostomy. With the minimally invasive version of this treatment method, transcanalicular laser dacryocystorhinostomy, we are able to treat epiphora in 85% of cases.Conclusions: Proper diagnosis and treatment of watering eye is important because of the impact of tearing on a number of eye processes. Incorrectly identified causes and treatment deteriorate patients' quality of life with decreased visual acuity and disrupted social contacts. In the article we show the contribution of the Eye Hospital in Ljubljana to the successful treatment of epiphora with transcanalicular diode laser-assisted dacryocystorhinostomy.
Cricopharyngeal achalasia in connection with autoimmune disorders in a pre-adolescent patient: a case report
Authors: Vučina Urška , Kotnik Primož , Orel Rok
Published: November 2017

Cricopharyngeal achalasia is an uncommon cause of dysphagia, especially in children. Congenital form is known in neonates and infants. In older children this disease has been reported in very rare cases and mostly in connection with neurological and muscular diseases. We present a case of a 12-year-old girl with a four-year history of dysphagia. Esophagogastroduodenoscopy, radiological contrast swallow study and esophageal manometric study confrmed the diagnosis of cricopharyngeal achalasia. Te patient was successfully treated with dilatation of the upper esophageal sphincter. An initial attempt of dilatation appears to be a safe and eﬀective option in the management of cricopharyngeal achalasia in children, and may prevent or at least postpone the need for myotomy. Following the diagnosis of cricopharyngeal achalasia, several autoimmune conditions were diagnosed. Our case report revealed that cricopharyngeal achalasia may occur in association with some other autoimmune conditions, and that autoimmunity may also play a role in cricopharyngeal achalasia itself
New monoclonal antibodies against bilitranslocase as a diagnostic tool in determining the progress of clear cell renal cell carcinoma
Authors: Bogožalec Košir Alexandra , Lukan Tjaša , Kukovec Mateja , Montanič Sendi , Snoj Vivijana , Čurin Šerbec Vladka , Rajčević Uroš
Published: November 2017

Background: Monoclonal antibodies (mAbs) are an important tool in diagnostics and research, especially when we are dealing with a protein marker of unknown primary structure as in the case of bilitranslocase (BTL). BTL is also expressed on kidney cells, where it acts as an organic anion transporter. We have shown earlier that there are diﬀerences in bilitranslocase expression in normal kidney cells versus early grade kidney cancer.Methods: We developed monoclonal antibodies against extra- and intra-cellular domains of bilitranslocase protein model. To also gain a deeper insight in bilitranslocase expression in clinical samples, we assessed BTL expression in diﬀerent grades of clear cell kidney cell carcinoma (ccRCC).Results: Both new monoclonal antibodies bind to a protein in UOK171 cells but not in the negative control. Binding of mAb is specifc. mAb produced by cell line 2A9/2E9 (peptide 298–310; intracellular domain) is more suitable for immunohistochemical analyses as it gives stronger intensity of binding than mAb produced by cell line 11C9/2G9 (peptide 235–246; extracellular domain). Antibody 2A9/2E9 stains bilitranslocase in proximal renal tubules of normal kidneys but not in the surrounding stroma. Staining decreases in grade I compared to normal kidney, gradually increases in grades II and III, and decreases again in grade IV of ccRCC tissue.Conclusions: Our results show that these antibodies can be used in diﬀerent immunoassays. Furthermore, specificity and afnity of our mAbs allowed us to use them in the analysis of progressive grades of clear cell renal cell carcinoma in a limited number of patients. Tus, mAbs developed here can be used as a diagnostic tool that could help distinguish between early and late grades of clear cell renal cell carcinoma.
Telemedicine support to patients with chronic diseases for better long-term control at home
Authors: Rudel Drago , Slemenik-Pušnik Cirila , Epšek-Lenart Metka , Pušnik Stanislav , Balorda Zdravko , Lavre Janez
Published: November 2017

Authors in many scientific publications suggest that the telemonitoring of health parameters is a useful tool for supporting patients with long-term conditions staying at home and their self-management of the disease. Those patients are likely to benefit from timely and adequate response to deteriorated conditions detected by the telemedicine system. Almost all of the studies state that telemedicine provided as telemonitoring can be an eﬀective add-on tool in the hands of patients and medical experts for the self-management of patients with, for example, heart failure or diabetes. In this paper the principles of patient telemonitoring are presented as applied within a telemedicine service provided by the Centre for Telehealth (CEZAR) at the General Hospital Slovenj Gradec (Slovenia). The centre supports patients with diabetes mellitus type 2 and/or with chronic congestive heart failure. The service was set-up in 2014 as part of a European project called UNITED4HEALTH. Since then over 550 patients from the Carinthia and Saleška regions (Slovenia) have been receiving telemedicine support for more than two years. The clinical outcomes of the telemedicine service published elsewhere prove that the selected telemedicine service model is adequate and the implemented technological solution is acceptable for all service users: the patients and the clinicians.
Razvoj radiologije na Slovenskem
Authors: Zupanič Slavec Zvonka , Krek Anja , Kuhelj Dimitrij
Published: November 2017

Few discoveries in the history of science brought such significant progress as did the discovery of X-rays by the German physicist Wilhelm Conrad Röntgen in 1895. The finding did not only bring a revolution to the field of medicine but also to many other technical branches. With technological progress in the 20th century, medical roentgenology swiftly developed. The first significant step forward was the introduction of contrast media followed by others including computerised image data management and digital techniques. Medical diagnostics embraced other imaging methods based on other types of energy such as ultrasound and magnetic resonance imaging. The beginnings of roentgenology in the Slovene Lands go back to the year 1900. Bone fractures were the first to be imaged, followed by thoracic imaging and contrast imaging of the gastrointestinal tract. The use of roentgenology spread significantly after World War I, with the implementation in the following years of X-ray machines in all Slovenian hospitals, some spas and sanatoria. Gradually the need for an independent scientific institution emerged, which led to the establishment of the Roentgenological Institute for Slovenia and Istria in Ljubljana in 1923. At the same time radiology was developing also by other Slovenian hospitals.In the 1950s, Slovenian roentgenology increasingly stayed in touch with contemporary international development, updated its equipment and introduced new methods. The modern concept of centralised radiological management, comparable with that of modern European institutions, was realised in Ljubljana in 1973 after the relocation of the Radiological Institute to the new facilities at the Ljubljana University Medical Centre. The first computer tomography machine was installed in 1980, the first ultrasound machine was acquired in 1981, the first digital subtraction angiography (DSA) machine was introduced in 1986 and the first magnetic resonance machine was installed in 1993. The Clinical Radiology Institute, Ljubljana University Medical Centre, performs ambulatory and hospital radiological management at the secondary and tertiary levels for patients from the region of Ljubljana and from the rest of the country. A sophisticated radiology is also at the University Medical Centre Maribor. In the first decade of the 21st century radiology developed particularly quickly, bringing recent developments in international radiology to Slovenia, especially in the field of interventional radiology.
Infekcijski endokarditis v regionalni bolnišnici – Analiza primerov v letih 2005–2014
Authors: Jeraj Luka , Černič Šuligoj Nataša , Lejko Zupanc Tatjana
Published: November 2017

Introduction: Infective endocarditis (IE) is a serious disease with a high mortality rate and is defned as an inﬂammation of the endocardium, caused by microorganisms. Most data about IE originate from referral hospitals, therefore we aimed to analyse the demographics, presentation, diagnostics, treatment and outcome of IE at a regional hospital (Izola General Hospital–SBI) in a 10-year period.Methods: We analysed 51 episodes of IE and compared patients who were treated at a regional hospital alone, to those transferred to a referral centre. We also included data about all IE patients in a large referral hospital (University Medical Centre Ljubljana–UMCL).Results: Gender and age of the patients in SBI were similar to UMCL patients, however, there was a slightly higher share of IE in drug users and lower of prosthetic valve endocarditis. Our patients more often had streptococcal and less often staphylococcal endocarditis. Fewer patients needed surgery and time to operation was 17 days (median). Twenty-six percent of the patients died in the hospital. Approximately a half of the patients were transferred to a referral hospital, more often younger patients and women. The transferred patients often underwent surgery.Conclusions: Good cooperation with a referral hospital ensures that the outcome and other data of IE patients treated at a regional hospital are comparable to those in the literature. Some diﬀerences between patients treated in the regional hospital and the referral centre were observed. Time from admission to surgery could be shortened.