bluuebunny/crossref_metadata_2025 huggingface dataset:
Resolubilidade dos serviços ofertados na estratégia saúde da família: discurso de homens
Authors: Palmeira Saemya dos Santos , Pereira Tallita Moura , Almeida Tatiane Lôbo de , Sousa Anderson Reis de , Alencar Delmo de Carvalho
Published: February 2023

Objetivo: Descrever a percepção de homens sobre a resolubilidade dos serviços de saúde ofertados pela Estratégia Saúde da Família. Métodos: Trata-se de estudo qualitativo, em que os dados foram coletados por meio de entrevista semiestruturada junto a quinze homens adscritos em área de abrangência de uma equipe da Estratégia Saúde da Família do município de Feira de Santana-BA, Brasil. Os depoimentos foram trabalhados de acordo com a Análise de Conteúdo, segundo Bardin, na qual emergiram as categorias: “Desconhecimento das ações direcionadas à saúde de homens implementadas na Estratégia Saúde da Família” e “Limitações estruturais dos serviços ofertados pela Estratégia Saúde da Família que implicam na resolubilidade e na qualidade do atendimento”. Resultados: Revelaram opiniões heterogêneas quanto aos serviços oferecidos pela referida Estratégia, com predomínio de julgamentos negativos em virtude da dificuldade em conseguir consulta médica e demora na marcação de exames, além da escassez de profissionais e médicos especialistas nos serviços de atenção primária. Conclusão: Constatou-se necessidade de haver reestruturação nas unidades básicas de saúde, bem como na atuação dos profissionais, com vistas a atender as demandas de saúde da população masculina.Palavras-Chave: Estratégia Saúde da Família; Integralidade em Saúde; Saúde do Homem; Saúde Pública.
Vivências na graduação em Psicologia: discutindo a saúde mental dos universitários
Authors: Rozeira Carlos Henrique Barbosa
Published: February 2023

Objetivo: identificar e discutir fatores relacionados à saúde mental de estudantes universitários. Métodos: trata-se de um relato de experiência, realizado por acadêmicos do Curso de Psicologia do Centro Universitário Redentor (UniRedentor), ocorrido em outubro e novembro de 2017. As informações foram coletadas por meio de observação, aplicação de instrumentos e análise documental. Para fundamentar a pesquisa foi inicialmente realizado um levantamento bibliográfico em literatura científica, a partir da compilação de trabalhos publicados em revistas, livros especializados, pesquisas institucionais, bem como outras fontes necessárias. Resultados: Algumas das atividades desta prática foram aplicações de instrumentos de entrevistas, assim os resultados da pesquisa corroboram as afirmativas tangíveis ao sofrimento psíquico, onde mais de 70% (setenta por cento) dos universitários indicaram alteração do estado humoral durante o período de avaliações. Revelou-se também que 69% (sessenta e nove por cento) dos alunos desconhecem o verdadeiro sentido de estar saudável e 59% (cinquenta e nove por cento) consideram o ingresso na universidade como fator atenuador de problemas na saúde mental.  Conclusões: É importante o desenvolvimento de ações de apoio psicológico aos universitários com efetiva atividade e divulgação, objetivando diminuir problemas psíquicos, o que poderá se refletir na diminuição da prevalência da sintomatologia depressiva, de ansiedade, ideação suicida e dificuldades de relacionamento, contribuindo para que o aluno tenha uma qualidade de vida mais saudável durante sua fase de construção de conhecimentos.
The Development of Sustainable Tourism in Kendari City, Indonesia, During the COVID-19 Pandemic Based on the Local Wisdom Approach
Authors: Hairani Idrus Sitti , Akib Haedar , . Anshari , . Rifdan
Published: February 2023

The COVID-19 pandemic impacted the tourism sector all over the world. The direction of Kendari’s local wisdom approach to tourism development is still unclear, making Kendari City an unpleasant tourist destination. The pandemic must be seen as a baseline to rebuild the tourism sector. This paper analysed the local wisdom approach to developing sustainable tourism in Kendari City using a literature study. The study provides recommendations that can be implemented in developing the tourism sector.
Keywords: Covid-19, Sustainable Tourism, Local Wisdom, White Leg Shrimp Business
Speech Acts in the ``Say It Loud'' YouTube Video
Authors: Insan Nur , Amalia Fina , . Masri , Martisa Ela , Ino La
Published: February 2023

This study aimed to describe the types of speech acts in the ”Say It Loud” YouTube video by Azie and Evelyn. This study found that there were three types of John R. Searle’s speech acts in the video. Those are the Locutionary Act, the Assertive Illocutionary, and the Perlocutionary Act. The Assertive Illocutionary Act was the most used speech in the video. It was concluded that the illocutionary and perlocutionary speech acts make this video interesting and informative.
Keywords: Speech Act, Locutionary Act, Illocutionary Act, Perlocutionary Act.
Mapping the Focus of the Sustainable Development Goals in Resolving the COVID-19 Pandemic's Impacts: An Overview of Asia
Authors: Krisnawati Astrie
Published: February 2023

The outbreak of the COVID-19 virus forced some changes in the strategy to achieve the Sustainable Development Goals in some Asian countries. Applying a systematic literature review and middle-range theory of several previous studies from journal articles in the Science Direct database, this qualitative study aims to do the mapping of the focus of Asian countries in resolving the COVID-19 pandemic through their efforts to achieve SDGs. The results of this research will give recommendations to the governments of Asian countries regarding the focus of SDGs.
Keywords: Sustainable Development Goals, COVID-19, Pandemic, Asia
General English Lecturer Professionalism (A Case Study at USN Kolaka)
Authors: . Roslina , . Hanna , Lio Asrun , . Nasrul
Published: February 2023

This study aimed to describe the reflection of the professionalism of general English lecturers at USN Kolaka. This reflection was very important as the first gateway for evaluating the quality of general English learning at USN Kolaka. The study was motivated by the university’s low state of general English learning. For this purpose, this study used a qualitative descriptive method. Data were collected through questionnaires and in-depth interviews with 8 (eight) general English lecturers at USN Kolaka. The results of the questionnaire showed that the 8 (eight) lecturers reflected on their professionalism at a high level, In contrast, the results of the interview confirmation showed that every professional indicator has been carried out but not optimally. Thus, it was concluded that there was an effort by the general English lecturer at USN Kolaka to improve their professionalism. This study recommends follow-up support from the university to increase the number of lecturers in terms of good governance management process for lectures welfare.
Um Método de Aproximação de Fluxo por Múltiplos Pontos Utilizando Diferentes Estratégias de Interpolação para Simulação de Reservatórios de Petróleo
Authors: Chaves Matheus Araujo , Santos Emanoel Rodrigues dos , Contreras Fernando Raul Licapa
Published: February 2023

No presente trabalho, buscamos apresentar uma discretização robusta e acurada, baseada no método dos volumes finitos, da equação de pressão em reservatórios de petróleo com meios altamente heterogêneos e anisotrópicos, adotando malhas poligonais distorcidas. Esta metodologia de discretização é baseada em um método de aproximação de fluxo por múltiplos pontos com estêncil quase local (MPFA-QL). Este tipo de abordagem ocorre através de uma decomposição co-normal que determina o sentido físico do fluxo na superfície de controle. Assim, construímos os fluxos unilaterais para cada superfície de controle e, em seguida, obtemos uma expressão de fluxo único por meio de uma combinação convexa destes. Assim, as variáveis auxiliares localizadas nos vértices que definem as superfícies de controle são interpoladas utilizando diferentes estratégias de interpolação. Nosso objetivo é analisar e categorizar como a robustez e acurácia da solução numérica para a equação de pressão são influenciadas pelas diferentes estratégias de interpolação adotadas.
Tratamiento tributario de las cooperativas en el Uruguay
Authors: Lamenza Álvarez Alfredo
Published: February 2023

El tratamiento tributario de las cooperativas en Uruguay ha sido y es fragmentario, falto de coordinación, falto de uniformidad y actualización, sectorial y difícil de interpretar generando inseguridad jurídica. Inveteradamente, se ha utilizado el instrumento de la exoneración tributaria desconociendo las situaciones de no sujeción que se da en los impuestos al consumo y a la renta empresaria, aún luego del reconocimiento legal general del acto cooperativo. El fundamento del tratamiento tributario diferencial de las cooperativas estriba en sus especiales caracteres, su concepto de empresa sin fines de lucro y en sus valores y principios. Las cooperativas en el Uruguay se encuentran generalmente exoneradas del impuesto a la renta empresaria, del impuesto al patrimonio y, en algunos casos del aporte patronal, a la seguridad social, sin perjuicio de otras exoneraciones menores o particulares.

Recibido: 03 noviembre 2022Aceptado: 10 enero 2023
Therapeutic Plasma Exchange in Adult Patients with COVID-19 and Severe Pneumonia: Single Center Experience of Eighty Patients
Authors: AYGUN Bilal , PEPEDİL TANRİKULU Funda , KOYUNCU Mahmut Bakır
Published: February 2023

Aim: Therapeutic plasma exchange (TPE) is a frequently discussed treatment modality in severe coronavirus disease 2019 (COVID-19) patients. It requires an apheresis device and experienced personnel for the application. In this study, we aimed to reveal the characteristics and clinical outcomes of adult patients with COVID-19 who experienced TPE.
Material and Methods: Adult patients who had undergone TPE in our apheresis unit were retrospectively analyzed and COVID-19-positive cases were included in the study. All the medical information about the cases was obtained from the electronic database and technical details of the procedures were gathered from apheresis unit records.
Results: A total of 80 patients with a median age of 60 (19-85) years were included in the study. Severe pneumonia was present in 98.8% (n=79) of the cases. More than three-quarters of the patients had lymphopenia, critically elevated C-reactive protein (CRP), and D-dimer, and 41.0% (n=32) had high ferritin. The median length of stay in the intensive care unit was 26 (5-124) days. The mortality rate observed on the 14th and 28th days following the TPE procedure was 51.3% (n=41) and 75.0% (n=60), respectively. High ferritin level, multiple organ failure (MOF), and intubation were parameters found to be associated with mortality in the multivariate analysis.
Conclusion: The mortality rate observed in patients with COVID-19 who underwent TPE in our study was similar to the cases in the literature without the procedure, while it has been shown that high ferritin levels, intubation, and the presence of MOF increase the risk of mortality.
Letter to the editor / Uvodnik
Authors: Rebolj Danijel
Published: February 2023

The Chinese proverb says »A healthy person has a thousand wishes, a sick person only has one«. I guess there is no physician without such an experience in their daily practice. According to several surveys, health is our greatest value; however, we only begin to appreciate it, when it is no longer there. At that point, a disease appears as a negation of our health and treatments required. Medicine, scientifically dealing with treatment, comes into play. Medicine is, of course, more than just science. It comprises everything that stimulates health, cures and prevents diseases. Principally, medicine is about humanity, philanthropy and helping people not to be taken ill (prophylaxis),to recover (curative) and to suffer as little as possible (palliative). At least this is how it is supposed to be, and I believe it truly is. One expects from physicians not only to be sensible, but also good individuals, thus placing great responsibility on their hands.
Rheumatoid Arthritis and Atherosclerosis
Authors: Holc Iztok , Pahor Artur
Published: February 2023

Life expectancy of rheumatoid arthritis (RA) patients can be reduced by 3–18 years. Cerebrovascular and cardiovascular events (myocardial infarction and stroke) as a consequence of accelerated atherosclerosis are the main cause of death in RA patients. Atherosclerosis is a widespread pathologic process in medium– to–large arteries responsible for cardiovascular diseases. Atherosclerosis shares many similarities in immune– pathophysiological mechanisms with autoimmune inflammatory diseases such as RA.

Classical and non–classical risk factors are the cause for accelerated atherosclerosis in RA patients. Non–classical risk factors include some specific biochemical substances (homocysteine, cystatin C, lipoproteins) as well as inflammatory cytokines and adhesion molecules.

For the diagnosis of accelerated atherosclerosis in RA patients, ultrasound of internal carotid arteries with measurement of intima media thickness can be employed.

Here, we describe the practical factors involved in the diagnosis of accelerated atherosclerosis in RA patients.
Burnout syndrome – a serious danger in modern societies / Sindrom izgorelosti – resna nevarnost sodobne družbe
Authors: Pahor Dušica
Published: February 2023

We often hear people say that they are tired, exhausted, and unable to carry on in their private, as well as their professional lives. Sadly, this has become the accepted norm and is considered part of modern society; where exhaustion and fatigue have their places alongside mobile phones and computers. Have we accepted and become resigned to this situation?
Radiographic characteristics of impacted teeth
Authors: Fekonja Anita
Published: February 2023

Purpose: This study was performed to determine the prevalence, infraosseous position and treatment outcome of impacted teeth in patients treated at our Orthodontic Department over an 11-year period.

Methods: This retrospective study of orthodontic records was performed on 1,909 patients, who were examined for impacted teeth. It comprised panoramic radiographs, anamnestic and clinical data. We determined the number of subjects with impacted teeth and the number, type and location of the impacted teeth in these subjects. We were also interested in the duration of orthodontic traction with the purpose of bringing the impacted teeth into the dental arch.

Results: Sixty-three (3.3%) out of 1,909 treated orthodontic patients were found to have at least one impacted tooth. A maxillary canine (2.4%) was the most frequently impacted tooth, followed by maxillary and mandibular premolars (0.4%). The majority of patients had one (73%) or two (25.4%) impactedteeth. Maxillary impacted canines required the longest duration of orthodontic traction.

Conclusion: When orthodontic treatment is performed on patients with impacted teeth, not only the number and the type of the teeth but also the infraosseous position of impacted teeth and their relationship to adjacent structures should be taken into consideration.
Incidence of surgical site infections in a tertiary hospital in Slovenia
Authors: Taskovska Dragana , Flis Vojko
Published: February 2023

Purpose: Surveillance is an essential element of surgical site infection (SSI) prevention. Few studies have evaluated the long-term effect of these programs in Slovenia. SSIs are among the most commonly reported health care-associated infections, yet there is a paucity of data on SSI from Slovenia. We aimed to determine the incidence of SSI and explore its associated factors at a tertiary hospital in Slovenia.

Methods: Direct and indirect surveillance methods, based on European Centre for Disease Control andPrevention guidelines, were used to define SSI. Patients were followed at 30 days and 1 year postoperatively. Demographic and medical data were collected and risk factors were assessed. Risk factors for SSI and the effect of surveillance time on SSI rates were statistically analyzed.

Results: Of 8074 patients analyzed, the SSI rate was found to be 0.28%. One of the statistically significant risk factors for SSI included age (average age 66 years vs. 58 years: p=0.0206, t=2.315, p<0.005). Other known risk factors, such as disease severity, presence of drains, history of previous hospitalization,preoperative stay, wound classification, and surgery duration did not influence the outcome in this study.

Conclusion: The incidence of SSI at our hospital was lower than reported in many comparable studies. We establish baseline data for targeted implementation strategies to further improve the quality and safety of health care in this and similar hospitals in Slovenia.
comparative study of Virtual Microscopy versus Traditional Microscopy for introduction into the Histology Curriculum at a Faculty of Medicine
Authors: Prunk Tanja , Zdravković Bogdan , Munda Miha
Published: February 2023

Purpose: We currently employ traditional microscopy with glass slides for teaching purposes. Here, we performed a pilot survey on the potential implementation of virtual microscopy. Experienced peer tutors were asked to participate in the evaluation of virtual microscopy versus traditional microscopy. Our main objectives were to determine: whether there is a statistically significant difference in time to locating a structure on a glass slide versus a virtual slide, the possible advantages and disadvantages of each microscopy method, and the benefits of virtual microscopy over traditional microscopy (1-3).

Methods: Glass slides were scanned with the Aperio ScanScope CS slide scanner for use as virtual slides. Peer tutors were asked to locate the same structures on each glass slide and the corresponding virtual slides. Times needed to locate these structures were individually measured, and a questionnaire (a modified and translated version of the College of Veterinary Medicine, North Carolina State University virtual microscopy survey) on the advantages of practical use of virtual microscopy provided at the end.

Results: One sample t-test showed significant differences (p<0.01) in mean time to locate a structure on glass (23.0s) versus virtual slides (12.5s). In commentaries, peer tutors reported a preference for a combination of traditional and virtual microscopy in practical sessions.

Conclusions: Assessors considered virtual microscopy easy to use. Time needed to locate a structure on virtual slides was significantly shorter. After additional surveys, we envisage successful implementation of virtual microscopy in conjunction with traditional microscopy in the histology curriculum.
Gastric cancer in pregnancy – diagnostic and therapeutic dilemma: Case Report
Authors: Kuder Lucija , Dovnik Andraž , Horvat Matjaž , Takač Iztok
Published: February 2023

Background: Gastric cancer during pregnancy is a rare disease that is difficult to diagnose due to the overlapping symptoms of cancer and normal pregnancy.

Methods: We present the case of a 31-year-old patient who was admitted in the 36th week of pregnancy with complaints of digestive disturbance, nausea and vomiting. Severe sideropenic anemia and the presence of blood in stools prompted us to perform gastroscopy, which showed an exulcerated lesion of the lesser curvature of the stomach. Histology revealed poorly differentiated adenocarcinoma with mixed tubular and signet ring cells.

Results: Cesarean section followed by total gastrectomy with dissection of the regional lymph nodes and omentec tomy was performed on the 10th day after admission. The patient refused postoperative radiotherapy and chemotherapy and died 11 months and 2 weeks after gastric resection.

Conclusion: There are no approved guidelines for the management of gastric cancer during pregnancy. Treatment is determined according to the gestational age of the fetus and the extent of gastric cancer at the time of diagnosis. The patient’s wishes must also be taken into consideration. Non-invasive methods should be used during pregnancy and invasive methods should be avoided whenever possible.
Faculty of Medicine, University of Maribor – the students’ perspective / Medicinska fakulteta Univerze v Mariboru – mnenja študentov o študiju
Authors: Pahor Dušica
Published: February 2023

Are we good? Are we not so good? How are we compared to others? These are the questions we keep asking ourselves. What is it that will make us better and lead us to become the best?
Cervical spine fractures in ankylosing spondylitis: a case report and literature review
Authors: Kunej Tomi , Movrin Igor
Published: February 2023

Purpose: Cervical spine fractures are a major cause of morbidity and mortality in patients with ankylosing spondylitis. These fractures are usually the cause of minor trauma and unstable in nature and, therefore, should be treated surgically.

Case report: Although the optimal choice of treatment remains a matter of discussion, combined anteroposterior or 360° fixation should be performed. Here, a case of a 48–year old male patient with an isolated C6 fracture that was treated with 360° fixation with good results is presented along with a review of the current literature on this topic.

Conclusion: Fractures of the cervical spine in ankylosing spondylitis should be treated with a 360° fixation, as this method enables the best treatment results.
Amiodarone-associated bilateral optic neuropathy: a case report
Authors: Bečić Turkanović Anela , Pahor Dušica
Published: February 2023

Purpose: Amiodarone is a commonly prescribed anti-arrhythmic drug; however, its use is limited by many adverse effects. Amiodarone causes lung, thyroid gland, skin, central nervous system, liver, and eye disorders. Corneal microdeposits are the most common ocular adverse effects, while more serious tissue damage such as optic neuropathy can also occur. The aim of this report was to describe a case of a toxic optic neuropathy, which is one of the adverse effects of amiodarone treatment.

Case report: This is a case report of a 51-year-old patient hospitalized at the Department of Ophthalmology University Medical Center Maribor because of blurred vision, first in his right eye and later in his left eye. Three months before admission, the patient began treatment with amiodarone because of arrhythmia after acute pericarditis. The patient underwent a complete ophthalmic examination and other tests for all known optic neuropathy causes. The patient initially presented with blurred vision in his right eye, and also in his left eye after 7 days. Except for corneal micro-deposits and optic disc edema, the results of an ophthalmic exam were normal. Static and kinetic visual field examinations showed bilateral visual field defects. Fluorescein angiography showed bilateral fluorescein dye leakage from the optic disc. Amiodarone treatment was terminated on the 7th day of hospitalization, and the patient reported improvement of vision in subsequent weeks. The edema in his left optic disc resorbed at 3.5 weeks and in his right optic disc at 5 weeks after termination of amiodarone treatment. Kinetic and static perimetry showed improvement in the visual field 10 weeks after the termination of amiodarone treatment.

Conclusions: Toxic optic neuropathy had a similar clinical course as non-arteritic anterior ischemic optic neuropathy. Prompt diagnosis is crucial because treatment with amiodarone can prevent irreversible visual impairment. Because of the frequent clinical use of amiodarone, and despite the low incidence of toxic optic neuropathy, regular annual follow-up examinations should be performed.
Determining high risk for squamous intraepithelial lesion progression in patients with recurrent or persistent HPV 16/18 infection: is there a role for biomarkers?
Authors: Arko Darja , Sobočan Monika , Takač Iztok , Bračič Suzana
Published: February 2023

Monitoring of low grade and early treatment of recurrent high grade squamous intraepithelial lesions (HSILs) are the cornerstones of cervical cancer prevention. Although current knowledge provides us with the ability to identify patients at risk for redeveloping HSIL, specifically patients with persistent human papilloma virus (HPV) 16 and 18 infection after conization, the danger of surgical overtreatment of these women with persistent infections remains. Complementary diagnostics encompassing the pathobiology of disease progression need to be evaluated. This perspective presents novel evidence that HPV methylation, c-MYC gene methylation, and co-expression of targeting protein for Xenopus kinesin-like protein and programmed death ligand 1 had a positive predictive value in determining which cervical lesions progress to high grade or spontaneously regress.
Varus knee deformity in adolescent soccer players
Authors: Krajnc Zmago , Vogrin Matjaž
Published: February 2023

The lower limb axis develops dynamically throughout the first and second decades of life. In recent years, with respect to youth athletes, we have been facing a progressive increase in the intensity of exercise during training and competition (involving increased time, frequency, and power), and, as a result, there hasbeen an increase in the number of acute and chronic overuse injuries. There are some sports with a higher incidence of injuries, one of which is soccer. A review of literature for the past 15 years with a focus on varus knee deformities in adolescent soccer players showed that varus axial deformities of the lower limbsoccur more frequently in soccer players than in the general population and in athletes from other sport, probably due to the specific loading pattern in soccer training. Varus deformities alter knee biomechanics, which results in medial joint space overloading, and consequently an early onset of degenerative joint disease. In addition, bowlegs predisposes athletes to patellofemoral pain syndrome and meniscal lesions. The etiology of genu varum in soccer is thought to be multifactorial, ranging from the natural selection of players to mechanical overload of the proximal medial tibial growth plate. A growing number of clinical reports and animal studies have indicated that intensive sport training may precipitate pathologic changes of the knee joint growth plate, and even produce a growth disturbance.
1-year survival rate of ICU patients undergoing tracheotomy, a low volume hospital experience
Authors: Mohorko Janez , Markota Andrej , Čizmarevič Bogdan
Published: February 2023

Purpose: Many critically ill patients require a tracheotomy during their ICU (Intensive Care Unit) stay. The aim of this study was to determine how many patients that undergo this procedure survive the hospital stay and are alive 1 year after the procedure.

Methods: We retrospectively included 144 patients who had tracheotomies during their ICU stay at the UMC (University Medical Centre) Maribor in 2015 and compared the survival between patients hospitalized in the MICU (Medical Intensive Care Unit) and SICU (Surgical Intensive care unit).

Results: This study showed that survival after tracheotomy in critically ill patients is low. Only 9.7% of all patients live without a tracheostomy after 1 year. The differences that were statistically significant between the MICU and SICU were observed only after the discharge from the ICU, with more people survivingthe MICU stay.

Conclusions: There is little information involving 1-year survival rates of patients undergoing tracheotomies. We conclude that more studies regarding this issue need to be conducted.
The influence of smoking on the frequency and characteristics of complications following large loop excision of the transformation zone (LLETZ)
Authors: Gavrić Lovrec Vida , Erlah Tanja , Dobnik Sarah , Takač Iztok
Published: February 2023

Purpose: Large loop excision of the transformation zone (LLETZ) is the procedure of choice for treating patients with suspected or confirmed cervical intraepithelial lesions. Since it has been established that smoking impairs wound healing, we wanted to determine if smoking increases the incidence of themost common complications that follow the LLETZ procedure and how it affects their intensity and duration.

Methods: We included 434 patients that underwent the LLETZ procedure between 1993 and 2015 in the Department of Gynecology and Perinatology, University Medical Centre Maribor. Patients were asked to assess the intensity and duration of abdominal pain, vaginal bleeding and vaginal discharge after the procedure, and to complete a questionnaire on a daily basis. Data obtained from the questionnaires were then analysed.

Results: The study group consisted of 237 (54.6%) smokers and 197 (45.4%) non-smokers. After the LLETZ procedure, 237 (54.6%) patients noted the occurrence of vaginal discharge, 193 (44.5%) lower abdominal pain, and 181 (41.7%) vaginal bleeding. No significant difference was observed in terms of the incidence of the observed events when comparing smokers and non-smokers. The duration and intensity of vaginal discharge and pain were not significantly different between the two groups. Non-smokers experienced bleeding that was more severe than smokers.

Conclusions: According to the results of our study, smoking did not increase the incidence of vaginal bleeding, vaginal discharge, and lower abdominal pain following the LLETZ procedure, nor did it crucially influence their duration and intensity.
Early detection of neck lymph node metastases in breast cancer patients: the role of ultrasound and fine needle biopsy
Authors: Rebol Janez , Balon Peter , Kokol Peter , Lanišnik Boštjan , Takač Iztok , Dovnik Andraž , Fokter Dovnik Nina , Sobočan Monika , Arko Darja
Published: February 2023

Purpose: To analyze the distribution and pattern of neck metastasis in breast cancer (BC) patients.

Methods: The clinicopathological characteristics of 41 patients with BC and confirmed neck metastasis (NM) treated at our institution between 2010 and 2016 were retrospectively analyzed by reviewing medical records. The diagnosis of NM was confirmed by fine needle aspiration cytology, and node localization was classified into six levels according to Robbins' classification. Statistical analysis was performed using descriptive statistics, Pearson’s correlation and multidimensional correspondence analysis. All statistical analyses were performed using SPSS.

Results: At the time of neck ultrasonography, 34 (85%) patients had developed distant metastases, 38% of the patients were asymptomatic, and 17% had no palpable nodes. The average time from BC diagnosis to the development of NM was 5.8 years (range, 0–26 years). Lymph node metastasis occurred at level V in 53.7% of patients and level IV in 19.5% of patients. Two-level involvement occurred in 9.8% and one-level involvement in 75% of patients. There were significant correlations (p < 0.01) between patient age andtime from diagnosis to development of NM, age and stage of the disease, and stage and appearance of conglomerates.

Conclusion: The most common site of NM from BC was next to the supraclavicular fossa, although they occurred at other levels. Ultrasonography combined with fine needle aspiration cytology is effective for the detection of early occult metastatic lymph nodes.
Cumulative pregnancy and live birth rates following intrauterine insemination and in vitro fertilization in couples with unexplained infertility
Authors: Kozar Nejc , Kovačič Borut , Reljič Milan , Kovač Vilma
Published: February 2023

Purpose: There are multiple options for the treatment of unexplained infertility. Two of the most commonly used treatments are intrauterine insemination (IUI) and in vitro fertilization (IVF). The aim of our research was to analyze and compare the success rates of IUI and IVF procedures in the treatment of unexplained infertility.

Methods: This was a retrospective study including 914 cycles of IUI performed for 355 couples, and 302 IVF cycles performed for 161 couples. All cases involved unexplained infertility and were treated in our department between 2012 and 2014. We analyzed differences in pregnancy, live birth rate, multiple pregnancy rate, and predictive factors for IUI.

Results:There was a significant difference between IUI and IVF in terms of cumulative pregnancy and live birth rates after 4 cycles (22.0% vs. 71.8%; p < 0.001 for clinical pregnancy rates and 16.1% vs. 64.8%for live birth rate). Differences between the two techniques in terms of twin live birth rates were not significant (16.5% for IUI vs. 17.6% for IVF; p=0.936). Using logistic regression, we found that the duration of infertility, total sperm count, and the type of stimulation, were significant predictive factors for IUI (p = 0.014, p = 0.036 and p = 0.046, respectively).

Conclusion: As expected, according to pregnancy rate, IVF is a better option for the treatment of idiopathic infertility than IUI. However, IUI should not be underestimated since it offers reasonable success rates with significantly less invasiveness. To improve the outcome of treatment for unexplained infertility, we suggest that treatment methods should be chosen with respect to predictive factors.
The long-awaited study of dental medicine in the Faculty of Medicine at the University of Maribor (the MF UM) is to begin in the 2021/22 academic year / V akademskem letu 2021/22 se na Medicinski fakulteti Univerze v Mariboru začne dolgo pričakovani študi
Authors: Mičetić-Turk Dušanka
Published: February 2023

The great Chinese philosopher Confucius once said, “When you make the first step, you have already reached the goal.” The incentive to make the first step in the direction of organizing the study of dental medicine in the Faculty of Medicine at the University of Maribor (MF UM) came from the dental service of the Health Centre Dr. Adolf Drolc in 2016. At the MF UM, we immediately recognized the incentive as a great opportunity for sustainable development in the region; not only in the sense of educating doctors of dental medicine, but also as an opportunity to develop new, interdisciplinary cooperation between the various faculties of the University of Maribor in the fields of dental medicine, which include studies of new materials, nanoparticles, microbiology, genetics, biochemistry, and bioinformatics, among others. Thus, the painstaking establishment of the uniform Master's Program in Dental Medicine was initiated and concluded on January 09, 2020 by order of the Slovenian Quality Assurance Agency for Higher Education on programme accreditation ...
The role of modified vaginal microbiota on postoperative bleeding following large loop excision of the transformation zone (LLETZ)
Authors: Arko Darja , Rojko Tomaž , Cokan Andrej , Žebeljan Ivan , Takač Iztok
Published: February 2023

Purpose: To evaluate the effect of a modified vaginal microbiota containing various vaginal pathogens and Chlamydia trachomatis on postoperative bleeding following large loop excision of the transformation zone (LLETZ) of the uterine cervix.Methods: We performed a retrospective analysis of patients with cervical intraepithelial neoplasia (CIN) who underwent LLETZ at the Clinic for Gynaecology and Obstetrics, UMC Maribor, between 1993 and 2005. Cervical swabs were collected before the procedure to evaluate the presence of Chlamydia trachomatis and other genital pathogens. After the procedure, the occurrence and severity of postoperative bleeding was evaluated.Results: A total of 192 patients were recruited. A modified vaginal microbiota containing various vaginal pathogens and Chlamydia trachomatis was present in 5.2% of patients. The most frequently isolated groups of vaginal pathogens were group B streptococcus and Candida species. The occurrence of postoperative bleeding after LLETZ did not differ significantly when compared between groups with or without a modified vaginal microbiota containing various vaginal pathogens and Chlamydia trachomatis (50.0% vs. 37.9%, p = 0.512).Conclusion: Patients with cervical intraepithelial neoplasia (CIN) commonly exhibit a modified vaginal microbiota containing various vaginal pathogens and Chlamydia trachomatis. However, this is not an important risk factor for postoperative bleeding after LLETZ.
Accuracy and speed of molecular response reporting with Xpert BCR-ABL Ultra in vitro diagnostic test in CML patients
Authors: Stangler Herodež Špela , Kokalj-Vokač Nadja , Roškar Zlatko , Dreisinger Mojca
Published: February 2023

Purpose: The objective of this study was to introduce the GeneXpert Ultra cartridge-based BCR-ABL diagnostic test into routine molecular monitoring of minimal residual disease for chronic myeloid leukemia (CML) patients who are on tyrosine kinase inhibitors (TKIs).Methods: BCR-ABL1 transcript quantification was performed on 100 peripheral blood samples from 33 CMLpatients at different stages of the disease using automated GeneXpert BCR-ABL Ultra assay and following a standardized laboratory protocol (SP).Results: Analysis results were expressed as % on the International Scale (IS) for BCR-ABL1 real-time PCR quantification and estimated using molecular response (MR) according to the laboratory recommendations for scoring deep MRs following CML treatment. A comparison of the two methods showed that there was no statistically significant difference in the results expressed as % on the IS (p = 0.098). Samples were divided into six groups (MR1, MR2, MR3, MR4, MR4.5, and MR5) according to the estimated MR. A total of 74/100 samples had a completely identical MR with both methods, 12/100 samples had a higher MR obtained with GeneXpert, and 14/100 samples had a lower MR compared to the SP. In addition, 2/74 samples had a different MR for two classes obtained with GeneXpert compared to the SP, while the others 72/74 samples differed in one MR class. Analysis of the major molecular response resulted in 82% agreement. Minimal amounts of BCR-ABL1 copies were detected with GeneExpert in eight samples while the SP did not detect them. None of the GeneXpert results had any effect on the clinical decision for treatment with TKIsobtained using the SP.Conclusion: The Xpert BCR-ABL Ultra assay can be considered a useful and very fast clinical tool for molecular follow up of patients on TKIs.
Case report: delirium and hypothyroidism
Authors: Plemenitaš Ilješ Anja
Published: February 2023

Purpose: The purpose of this report is to present a clinical case of an elderly female patient with complex delirium suffering from hypothyroidism with a clinical manifestation of psychosis.Case report: After a preliminary diagnosis of acute confusion, a 70-year-old female patient was treated in the Centre for Emergency Medicine, Community Health Center and then by internists and neurologists. Afterwards, she was admitted to the Department of Psychiatry due to unexplained delirium. Acute hypothyroidism was detected upon further diagnosis. The patient was identified as suffering from acute hypothyroidism with an underlying cognitive decline.Conclusion: Hypothyroidism can present as changes in mental status and cognition, which can have a clinical manifestation of delirium and later psychosis that is also known as “myxedema madness”. This clinical case was treated causally with thyroid hormones and symptomatically first with clomethiazole and later with risperidone.
Case report: Is mid-trimester cesarean section an unrecognized risk factor for accidental extension to the lower uterine segment?
Authors: Al Mahdawi Leyla , Kuder Lucija , Mujezinović Faris
Published: February 2023

Purpose: Hysterotomy extension at the time of cesarean section is frequent and associated with severe blood loss, risk of transfusion, and unplanned hysterectomy. Cesarean section during the second stage of labor is the most important riskfactor.Case report: We describe a case of a 35-year-old gravida 4 para 1 at 26+1 weeks gestation who underwent a repeat cesarean section. An unintentional hysterotomy extension led to severe blood loss. The patient was discharged on day 4 after the operation in stable condition.Conclusion: Hysterotomy extension is associated with higher maternal morbidity and mortality. Blunt expansion of the hysterotomy and a reverse breech extraction are associated with a lower uterine tear rate.
Preoperative antibiotic prophylaxis in a single tertiary hospital in Slovenia—the role of education in recommendation compliance
Authors: Žnidarič Matej , Vogrin Matjaž , Moličnik Andrej , Mujezinović Faris , Kavčič Niko , Gorišek Miksić Nina
Published: February 2023

Purpose: The aim of the present study was to evaluate the impact of an educational intervention package on perioperative antimicrobial prophylaxis (PAP) prescription practice in three elective procedures—total hip arthroplasty (THA), caesarean section (CS), and radical prostatectomy (RP)—in a single tertiary care hospital in Slovenia.

Methods: An interventional study was performed to evaluate the impact of an educational intervention package on PAP compliance. PAP prescription practices for three elective types of surgery (THA, CS, and RP) were observed. Thirty operative reports for each type of surgical procedure were evaluated according to indication, timing of preoperative prophylaxis administration, antibiotic selection and dosage, and total prophylaxis duration. This was followed by an educational intervention package that included a discussion with department leaders led by an infectious disease specialist and an educational seminar and discussion for surgeons, supplemented by PAP recommendations provided as pocket reminders. Then, the compliance with PAP recommendations for the same types of procedures performed in the post-interventional period (3–6 months after the intervention) was evaluated again.

Results: Complete pre-interventional compliance with local guidelines was observed in 67%, 70%, and 3.3% of THA, CS, and RP cases, respectively. A major deviation from PAP recommendations was observed in the timing of preoperative PAP administration before surgery and in the total PAP duration A deviation from recommendations for RP, which is a major surgical procedure, was observed as a longer postoperative PAP duration compared to the intraoperative course. In the post-interventional period, an improvement in total compliance with PAP recommendations was observed in 80.0%, 90.0%, and 50.0% of THR, CS, and RP procedures, respectively.

Conclusion: Our study revealed an improvement in adherence to PAP recommendations after an educational intervention package for selected procedures at the University Medical Centre Maribor. This simple intervention can have an important impact on patient care quality by reducing antimicrobial medication use, resistance development, and treatment cost.
Child and adolescent mental health services during the COVID-19 epidemic in Slovenia: Comparison with other European countries
Authors: Gregorič Kumperščak Hojka , Podlesnik Peršak Ivan
Published: February 2023

Purpose: To evaluate the impact of the COVID-19 epidemic on child and adolescent mental health services (CHAMS) during the first and second epidemic wave.

Methods: Members of the Slovenian Association for Child and Adolescent Psychiatry (n=66) were invited to participate in the study. The survey involved two semi-structured questionnaires on CHAMS and clinical and organizational issues with respect to the first and second COVID-19 waves. The findings were compared with similar studies conducted in other European countries.

Results: Eighteen members fulfilled the first and seven the second questioner. Thirty-three percent of respondents reported that their CHAMS colleagues were assigned to the COVID-19 wards during the first and 43% in the second wave. The CHAMS were more affected by the public health measures for COVID-19 during the first wave. During the first wave, half of the respondents experienced worsening anxiety disorders, while an increase in all mental disorders was reported during the second wave.

Conclusion: A concerning finding of this study was limited access to CHAMS as a result of public health measures, especially during the first wave. But the provision of services in Slovenia was not as severely limited as elsewhere in Europe. CHAMS in Slovenia were able to provide better employee safety measures in terms of COVID-19 infections compared to other European countries. CHAMS employees in Slovenia were more frequently transferred to COVID-19 wards compared to their European colleagues, despite the fact that they were faced with increasing numbers of children and adolescents with mental disorders.
The importance of the correct choice of Franz diffusion cell volume for in vitro drug release testing of wound dressings
Authors: Maver Uroš , Maver Tina
Published: February 2023

Purpose: Wound dressings are one of the most commonly used products in wound care. Nowadays, various wound dressings are developed containing different active ingredients, often drugs from different pharmacodynamic groups. Considering the variable and changing environment in each wound type, it is important that the experimental design for evaluating the in vitro drug release of such materials takes into account these different conditions.

Methods: For this purpose, Franz diffusion cells for in vitro drug release testing are the method of choice, as they are not only able to simulate different conditions during wound healing but also allow for a certain degree of possible changes in the experimental design (e.g., diffusion cell size).

Results: In this study, we aimed to compare two Franz diffusion cells with different volumes of receptor medium to evaluate naproxen release from an alginate-based model wound dressing. We confirmed that the volume of the receptor medium not only affects the amount of drug released in the selected time but also significantly influences the release mechanism.

Conclusion: The different volumes of the Franz diffusion cell receptor compartments allow the simulation of wounds with a higher and a lower degree of exudation. The experimental design for in vitro drug release testing based on Franz diffusion cells must be based on a thorough consideration of the targeted wound type for which the dressings are being developed.
A prospective study of the correlation between infection of the uterine cervix and secondary bleeding after large loop excision of the transformation zone (LLETZ)
Authors: Arko Darja , Dovnik Andraž , Fokter Nina , Takač Iztok
Published: February 2023

Purpose: A prospective study was undertaken to evaluate the role of genital pathogens in postoperative bleeding necessitating secondary intervention after large loop excision of the transformation zone (LLETZ) of the uterine cervix.

Methods: A total of 1419 patients with cervical intraepithelial neoplasia (CIN) who underwent LLETZ were included in the study. To determine the presence of genital pathogens, cervical swabs were collected before the procedure. Postoperatively, patients were followed up for bleeding necessitating secondary interventions.

Results: Among 1419 patients, genital pathogens were present in 714 (50.3%) cases and absent in 705 (49.7%) cases. The most frequently isolated groups of microorganisms were group-B β-haemolytic streptococci, α-haemolytic streptococci, Enterococcus sp. and coliforms. Secondary procedures due to severe bleeding were required in 48 (6.8%) patients without and in 63 (8.8%) patients with genital pathogens, but this difference was not significant (chi-square test = 1.72; P>0.05).

Conclusion: These data suggest that genital pathogens are very common in patients with CIN and are not an important cause of postoperative bleeding necessitating secondary intervention after LLETZ.