bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of theophylline therapeutic drug monitoring service
Authors: Rugelj Neža , Trobec Katja Čvan , Pišlar Mitja , Brguljan Pika Meško , Košnik Mitja , Mrhar Aleš 
Published: November 2017

BackgroundTherapeutic monitoring of theophylline serum levels is required due to its narrow therapeutic range and marked interindividual pharmacokinetic variability. We evaluated therapeutic drug monitoring service for theophylline in Slovenian clinical setting, which currently includes no pharmacokinetic evaluation of measured theophylline serum concentrations. MethodsWe retrospectively evaluated 127 randomly selected theophylline serum level determinations performed in 2010 in a tertiary clinical setting in Slovenia. Demographic data, information on theophylline dosing and blood sampling was collected from patients’ data files. Authors evaluated the appropriateness of the following procedures: indications for theophylline serum concentration measurement, timing of blood sampling and dosage adjustments made after theophylline levels had been reported. On the basis of collected data, population pharmacokinetic model for theophylline was built and further used for the evaluation of dosage adjustments. ResultsOut of 127 cases, 107 (84.3%) had clinically justified indication for theophylline serum level measurement. Near half of measurements (44.9%) were performed before the steady state of theophylline concentrations was established. 65% of measured concentrations were subtherapeutic and the average measured concentration was below therapeutic range (53.1 μmol/L). Despite subtherapeutic concentrations the dose of theophylline was mainly not increased. Pharmacokinetic model enabled the calculation of average optimal daily dose which was significantly higher than the average actual daily dose used (876 mg vs. 572 mg, p < 0.001). ConclusionsTheophylline TDM service should be optimized and pharmacokinetic interpretation of theophylline serum levels should be integrated into clinical practice.
NOVOSTI V OBRAVNAVI PLJUČNE BOLEZNI PRI OTROCIH IN MLADOSTNIKIH S CISTIČNO FIBROZO
Authors: Praprotnik Marina , Kotnik Pirš Ana , Salobir Barbara , Oštir Majda , Turel Matjaž , Krivec Uroš 
Published: November 2017

Cystic fibrosis (CF) is a multi-organ disease, affecting mostly lungs and gastrointestinal tract. Data from patient registries show that the survival of patients with CF has progressively improved over the past several decades, as a result of advances in antibiotic treatment, supplementation of pancreatic enzymes, better nutrition and a holistic approach to treatment in CF centres.The purpose of this review is to survey recent developments in the treatment of lung disease in children and adolescents with CF.We describe newborn screening for CF.When chronic respiratory insufficiency occurs, lung transplantation becomes a very important issue.Lung disease is the most common cause of morbidity and mortality in CF patients. Emerging new therapies are targeted at all points in the pathogenesis of lung disease, from drugs that treat infection and inflammation in the airways to gene transfer studies and to drugs that augment airway surface liquid height. A number of antibacterial agents formulated for inhalation are at various stages of study and there are several anti-inflammatory candidate drugs in clinical trials. The most important development in the recent years is modulation of the abnormal protein that causes CF, the cystic fibrosis transmembrane regulator (CFTR), where drugs are targeted at specific defects in the transcription, processing or functioning.When chronic respiratory insufficiency occurs, lung transplantation becomes a very important issue. The role of the CF nurse, who has responsibilities in educating and teaching clinical skills to patients and families, is described.
Zdravljenje odporne arterijske hipertenzije z renalno denervacijo – da ali ne?
Authors: Accetto Rok , Salobir Barbara , Kuhelj Dimitrij , Božič Nina 
Published: November 2017

The true resistant hypertension is rare. The reasons are not entirely clear, but undoubtedly vegetative nervous system (renal afferent and efferent nerves) plays an important role. Surgical sympathectomy is effective but because of serious side effects is inappropriate. In recent years, a special catheter for endovascular renal radiofrequent denervation has been developed. With this method we have treated in accordance with the Slovenian and European recommendations, five patients with resistant hypertension. The radiofrequent ablation of renal arteries was not effective in our patients which is not what we expected because of the results of the first two non-randomized uncontrolled studies - Simplicity HTN 1 and 2. The third in a series of international multicentre studies - a randomized, controlled, single-blind study Simplicity HTN 3 showed, however, that renal denervation is not effective method for the treatment of resistant hypertension. A detailed overview of enrolled patients suggests that certain patients may be eligible for intervention, but have not yet been identified.
Diagnostični protokol za obravnavo okuženih sklepnih vsadkov
Authors: Mlekuž Alen , Trebše Rihard , Mihalič Rene , Levašič Vesna 
Published: November 2017

Infection is becoming the most important as well as the most devastating mechanism of prosthetic joint failure. The incidence is increasing due to increased sensitivity of orthopedic surgeons for this diagnosis, better diagnostics, and because the absolute number of operated patients is increasing and because more often very sick, debilitated, and immunocompromised patients are operated on. The trend shows the incidence to further increase in the years to come. The diagnosis may be very easy in case of high grade processes, but also extremely difficult in low grade infections. Misdiagnosing infection leads to repeat early failures and revisions that are distressing for patients as well as for surgeons. To avoid failures related to misdiagnosed prosthetic joint infections a step-wise algorithm of action is proposed and the diagnostic strength of the steps discussed. The key point is to select the potential candidates to define the possibility of an ongoing infection and then to select the tools to strengthen the suspicion. The further procedures base on the analysis of the pseudo-synovial fluid obtained by aspiration. The diagnostic conclusions form the basis for considered treatment decisions.
NOSEČNOST V JAJČNIKU PO PREDHODNO ZDRAVLJENI ISTOSTRANSKI TUBARNI NOSEČNOSTI PRI ŽENSKI V IVF-ET POSTOPKU ZARADI NEPLODNOSTI
Authors: Bizjak Neda , Klanjšček Jure 
Published: November 2017

Ovarian pregnancy is a rare condition. In article we report a case of ovarian pregnancy in a 42-years old woman who had already undergone an ipsylateral tubectomy because of an extrauterine pregnancy.Even though the patient showed no symptoms, the inadequate rise of β hCG and the ultrasound scan were suspicious for an ovarian pregnancy which was later confirmed, intrapoeratively as well as patohistologically.Some repeated values of β hCG did not show enough rise up and vaginal echography revealed atypical anechoic mass placed on or in the right ovary. The anechoic mass seen at right ovary become more and more tipical for gestational sac.In combination with the fact, that the uterine cavity was empty, without echo-signs of intrauterine pregnancy and becouse of her past experiance of extrauterine pregnancy, we soon decided to perform a diagnostic laparoscopy, which confirmed our suspicion. Gestational sac was laparoscopicaly removed.The ovary and ovarian tube on her left side were normal and without any changes of chronical inflamatory disease.
Otroška paraliza – pozabljena bolezen? Otroška paraliza na Stari Gori
Authors: Schincariol Michele , Savić Jasna , Zupanič Slavec Zvonka 
Published: November 2017

The following review article describes poliomyelitis and the management of children after the disease at the Hospital of Stara Gora in the years 1952–1962. The precious experiences of the experts, who treated patients with poliomyelitis and of physicians, who were affected by it, are a credible proof of the seriousness of the disease and of the need to keep a high vaccination rate in our society.
A patient with diplopia and upper eyelid edema: a case report
Authors: Šivec Trampuž Igor , Kosec Dragica 
Published: November 2017

Idiopathic orbital inﬂammatory disease, previously referred to as orbital pseudotumor, is a nonneoplastic, non-infective disease. The inﬂammatory process can involve one or more orbital sof tissues; extraocular muscles, tear gland, scleralorepiscleral tissue or orbital fat. Orbital myositis typically presents itself with a sudden onset of restricted ocular motility, diplopia, congestive proptosis, eyelid ptosis, periocular swelling and conjunctival hyperemia. A thorough workup is essential for ruling out other entities.This report presents a case of a 47-year old man with a sudden onset of right upper eyelid swelling and diplopia. Until then he had no health problems. Afer initial ophthalmologic workup and ultrasound an orbital mass was suspected. Te MRI and a biopsy of the mass confirmed an isolated superior oblique muscle myositis. We treated him with systemic steroids. A good response and fast regression were observed. In two years of follow-up visits no recurrence was noted.Isolated superior oblique muscle myositis is extremely rare. This is one of eleven cases documented between 1988 and 2015. This case report presents a 47-year old man with a sudden onset of right upper eyelid swelling and diplopia. Until then he had no health problems. After initial ophthalmologic workup and ultrasound an orbital mass was suspected. The MRI and a biopsy of the mass confirmed an isolated superior oblique muscle myositis. We treated him with systemic steroids. A good response and fast regression was observed. In two years of follow-up visits no recurrence was noted.Isolated superior oblique muscle myositis is extremely rare. This is one of eleven documented cases between 1988 and 2015.
DIAGNOSTIKA, ZDRAVLJENJE IN SPREMLJANJE ODRASLEGA BOLNIKA Z INTERMEDIARNIM UVEITISOM
Authors: Počkar Saša , Valentinčič Nataša Vidović 
Published: November 2017

Intermediate uveitis is a chronic inflammatory eye disease where the vitreous is the major site of the inflammation. It mostly affects younger patients. The inflammation can be idiopathic or related to either infectious or autoimmune systemic disease. The leading cause of visual deterioration in intermediate uveitis is cystoid macular edema and cataract is the most common complication.Criteria for treating intermediate uveitis depend on the cause of the disease. We consider the presence of cystoid macular edema, vitreous haze 2+ or more, retinal neovascularization or vasculitis. We decide to treat the patient early, because it is easier to preserve visual function and ocular structures. The basic approach to treatment is a »step approach«. We start the treatment with periocular, intraocular or systemic corticosteroids. If the treatment is ineffective we use immunosuppressants/immunomodulators. Prognosis is improved with early control of inflammation and early treatment of the complications.
Spremenjena aktivnost encima 5,10-metilentetrahidrofolat reduktaze (MTHFR) vpliva na razvoj številnih bolezni
Authors: Vidmar Maša , Grželj Jasna , Gersak Ksenija , Mlinarič-Raščan Irena 
Published: November 2017

The importance of folates in human physiology is well known, as are various pathologies associated with low folate status. Folate deficiency can occur due to low dietary intake, genetic predisposition or treatment with medicines affecting the folate status. The aim of this paper is to explore the importance of determining genetic polymorphisms which influence the levels of biologically active folate. MTHFR is involved in the transformation of 5,10-methylene-THF to 5-methyl-THF. Polymorphisms of the MTHRF gene are associated with decreased enzymatic activity.Only 9.3 % of the population in Slovenia displays full activity of the MTHFR enzyme; these subjects are non-mutated homozygotes (wild-type alleles). In contrast, the average enzymatic activity in subjects with mutated alleles is between 50 and 60 %. MTHFR polymorphism is associated with an increased risk of hyperhomocysteinemia and cardiovascular diseases, neurological disorders and various types of cancer. There is also an increased risk for congenital malformations. Folic acid food fortification was introduced in some countries in order to assure an adequate folate status in the population. However, this approach does not address the decreased activity of MTHFR.Polymorphism in the key enzymes of the folate cycle is common. Determination of the genetic predisposition is therefore plausible in the most vulnerable groups of the population, such as pregnant women and patients receiving medicines influencing the folate cycle in various ways, e.g. 5-fluorouracil, methotrexate and 6-mercaptopurine. Genotyping would allow the identification of patients at high risk for suboptimal folate status.
Zdravljenje diseminiranega plazmocitoma na Kliničnem oddelku za hematologijo UKC Ljubljana z avtologno presaditvijo krvotvornih matičnih celic v letih 2014 in 2015.
Authors: Zver Samo , Melkić Enver , Radevska Tanja 
Published: November 2017

Introduction. In the period from 01.01.2014 to 31.12.2015 at Clinical Department of Hematology, University Medical Centre Ljubljana, we treated 73 multiple myeloma patients with first autologous hematopoietic stem cell transplantation (HSCT).Methods and results. Age of patients ranged from 27 to 72 years with the median age of 60 years. Induction treatment at the time of diagnosis consisted of: VD (bortezomib, dexamethasone) 60/73 patients (82%), VCD (bortezomib, cyclophosphamide, dexamethasone) 10/73 patients (14%) and VTD (bortezomib, thalidomide, dexamethasone) 3/73 (5%) patients. As part of induction therapy, patients received from 1 to 9 cycles of treatment. Response to induction therapy prior to HSC(hematopoietic stem cells) collection was as follows: CR(complete remission )7/73(10%), VGPR (very good partial response) 28/73(38%), PR (partial response) 23/ 73(32%), SD (stable disease) 11/73(15%) andPD (progressive disease) 4/73(5%) patients. Response to induction therapy immediately prior to autologous HSCT: CR9/73 (12%), VGPR32/73 (44%), PR17/73(23%), SD 8/73(11%) and PD6/73(8%) patients. Response to induction therapy and the first autologous HSCT at D+100 after HSCT: CR9/67 (13%), VGPR 34/67 (51%), PR 12/67 (18%), SD 3/67 (4 %) and PD 7/67 (10%) patients (in 6 patients data are missing, because they are not mature yet). With single HSCT 63 patients were treated, while 10 patients received double or second HSCT. The overall mortality of patients treated during the period from 01.01.2014 to 31.12. 2015 was 6/73 or 8.2%.Conclusions. The treatment of multiple myeloma with autologous HSCT remains the cornerstone of efficiency,as demonstrated by the increasing share of the most desired responses to treatment, ie. CR and VGPR. The treatment mortality rate was within expectation limits.
Laparoskopska radikalna histerektomija z limfadenektomijo: naše izkušnje
Authors: Meglič Leon 
Published: November 2017

BackgroundThe second most common cancer in women up to 65 years of age is cervical cancer. Same cancer is the leading cause of death from gynaecological deseases worldwide.The standard procedure for cervical cancer treatment with FIGO stage including IB2 is radical hysterectomy sec. Wertheim-Meigs-Novak with or without adnexa with radical pelvic lymphadenectomy and/or para-aortic lymphadenectomy. In the last two decades has with the development of laparoscopy also developed laparoscopic radical hysterectomy .Laparoscopic radical hysterectomy with pelvic and para-aortic lymph nodes dissection was performed for the first time by Nezhat with coworkers in 1989.Laparoscopic radical hysterectomy with pelvic and/or paraaortic lymphnode dissection in treatement of cervical cancer including FIGO stage IB1 is performed at Dep Ob/Gyn UKC Ljubljana since 2013. The purpose of this article is to evaluate the morbidity and safety of the procedure. MethodsWe retrospectively reviewed the medical records of patients with cervical cancer who underwent laparoscopic radical histerectomy with pelvic and/or paraaortic lymphadenectomy from April 2013 to May 2016. Results34 patient were included, 32 patients with CC FIGO stage IB1, 1 patient with CC FIGO stage IB2, 1 patient with CC FIGO stage IIB.There were four (11,8%) bladder lesions, all of them were corrected during the surgery, but no ureteral lesion! There was one (2,9%) surgical revision right after the surgery due to assumption of bleeding (though there was no active bleeding found).Three patients (8,8%) had permanent urinary dysfunction – retention. One patient (2,9%) had dehiscence of vaginal vault after 4 months (after sexual intercourse)There was no ureterovaginal/vesicovaginl fistula after surgery! The mean operating time was 2 hours 55 min, mean admission time after surgery was 8,7 days, mean blood loss during operation was 291 ml. ConclusionsLaparoscopic radical hysterectomy is the method of choice in cervical tumors including FIGO stage IB1.Percentage of bladder lesions is part of learning curve.Our goal in future is to decrease the percentage of bladder lesions and to decrease the percentage of patients suffering from bladder dysfunction by using „nerve sparing“ technic.We expect, the same results for 5 year survival rate as with patients treated with classical radical hysterectomy.
Unemployment - Determinant of Quality of Life
Authors: Đurašinović Pejo 
Published: November 2017

The consequence of unemployment is a poor standard of the population. Life standard in the social and economic spheres transposes contradiction in the political system. Departure of professional forces abroad and losing most vital segments of the population in whose education and training is spent a fifth of the budget. Quality of life depends on many factors, of which in this paper we point out: the conditions in which we work and live, housing and health conditions, possibilities to meet the cultural, sports, entertainment, and numerous other requirements and needs of a modern man. Economic sphere determines the standard of living of every man.
Redirecting the Young People From Family to the Society, the Political Imperative
Authors: Đurašinović Pejo 
Published: November 2017

Relevance of this research is based upon the fact that the position of the youth in the Republic of Srpska, in a broader sense, is inseparable from recent intense events in the society. The attention has focused on their basic needs (employment, housing, health, sport), what family they have and what kind of family they want, their continued economic dependence upon the family, socio-psychological characteristics and interests.The results of this study indicate the necessity of precisely designed and differentiated social support of all relevant factors, youth organizations, but also the need of Establishing and standardizing the new forms of work that will remove barriers for inclusion of the youth in development processes and accelerate the resolution of the most actual issues that complicate the situation among youth in the Republic of Srpska.Fundamental problems of young people within the Republic of Srpska are recognized, depressing status, unemployment, lethargy, the lack of information, laid out a system of values and a deficit in the process of standardization of youth work. To what extent young people in the Republic of Srpska are in the diabolic situation shows the Statistic that states that the two-thirds of young people want to leave the Republic of Srpska.
Determination of Speciation and Bioavailability of Copper in the Lake Modrac With Geochemical Biotic Ligand Model (BLM)
Authors: Đonlagić Nusreta , Crnkić Aida , Divković Daliborka 
Published: November 2017

The results of investigation of inorganic and organic speciation of copper compounds in the lake Modrac, using the geochemical equilibrium model BLM (Biotic Ligand Model; USEPA 2007) and other geochemical models are presented, as well as toxicity and bioavailability of copper compounds in the lake Modrac for chosen biotic ligand of fish fathead minnow (Pimephales promelas). Speciation and bioavailability of copper complexes was investigated and toxicity levels for chosen biotic ligand determined. The influence of water chemistry on copper toxicity is predominant, and application of sophisticated BLM model enables the prediction of toxicity and bioavailability of copper.
Short-term effects of CO2 leakage on the soil bacterial community in a simulated gas leakage scenario
Authors: Ma Jing , Zhang Wangyuan , Zhang Shaoliang , Zhu Qianlin , Feng Qiyan , Chen Fu 
Published: November 2017

The technology of carbon dioxide (CO2) capture and storage (CCS) has provided a new option for mitigating global anthropogenic emissions with unique advantages. However, the potential risk of gas leakage from CO2 sequestration and utilization processes has attracted considerable attention. Moreover, leakage might threaten soil ecosystems and thus cannot be ignored. In this study, a simulation experiment of leakage from CO2 geological storage was designed to investigate the short-term effects of different CO2 leakage concentration (from 400 g m−2 day−1 to 2,000 g m−2 day−1) on soil bacterial communities. A shunt device and adjustable flow meter were used to control the amount of CO2 injected into the soil. Comparisons were made between soil physicochemical properties, soil enzyme activities, and microbial community diversity before and after injecting different CO2 concentrations. Increasing CO2 concentration decreased the soil pH, and the largest variation ranged from 8.15 to 7.29 (p < 0.05). Nitrate nitrogen content varied from 1.01 to 4.03 mg/Kg, while Olsen-phosphorus and total phosphorus demonstrated less regular downtrends. The fluorescein diacetate (FDA) hydrolytic enzyme activity was inhibited by the increasing CO2 flux, with the average content varying from 22.69 to 11.25 mg/(Kg h) (p < 0.05). However, the increasing activity amplitude of the polyphenol oxidase enzyme approached 230%, while the urease activity presented a similar rising trend. Alpha diversity results showed that the Shannon index decreased from 7.66 ± 0.13 to 5.23 ± 0.35 as the soil CO2 concentration increased. The dominant phylum in the soil samples was Proteobacteria, whose proportion rose rapidly from 28.85% to 67.93%. In addition, the proportion of Acidobacteria decreased from 19.64% to 9.29% (p < 0.01). Moreover, the abundances of genera Methylophilus, Methylobacillus, and Methylovorus increased, while GP4, GP6 and GP7 decreased. Canonical correlation analysis results suggested that there was a correlation between the abundance variation of Proteobacteria, Acidobacteria, and the increasing nitrate nitrogen, urease and polyphenol oxidase enzyme activities, as well as the decreasing FDA hydrolytic enzyme activity, Olsen-phosphorus and total phosphorus contents. These results might be useful for evaluating the risk of potential CO2 leakages on soil ecosystems.