| Publisher: Slovenian Academy of Medical Science
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Zdravniski Vestnik : Slovenian Medical Journal
Number of Followers: 0  Open Access journalISSN (Print) 1318-0347 - ISSN (Online) 1581-0224 Published by Slovenian Academy of Medical Science  [1 journal]
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- Skin conductance algesimeter as a method for pain response assessment in
newborns
Authors: Joanna Prusnik, Janja Grženič, Aneta Soltirovska Šalamon
Pages: 3 - 10
Abstract: Background: Painful experiences of the newborn lead to short and long-term consequences making prompt recognition and treatment of pain crucial. Skin Conductance Algesimeter (SCA) is a new, non-invasive, objective method to measure pain resulting from an autonomic response to stress or nociceptive stimuli. These activate the sympathetic nervous system leading to increased perspiration of the palms and soles which in turn amplifies skin conductance. We aimed to define the clinical significance of nociception control by measuring skin conductance in newborns exposed to painful stimuli and assessing its potential introduction into clinical practice. Methods: The sample of our prospective study consisted of 35 newborns treated at the Department of Neonatology, Paediatric Division of the University Medical Centre Ljubljana, from 1 October 2020 to 30 April 2021. Physiological-parameter measurements, pain assessment using the NIPS and NPASS scales, and skin conductance measurements were performed 5 minutes before, during, and 5 minutes after the nociceptive stimulus. The statistical analysis was carried out using Friedman’s two-way analysis of variance by ranks with post hoc tests, Mann-Whitney U test, and logistic regression. Results: Skin conductance changed significantly during painful stimulus in comparison with measurements before or after painful stimulus (p=0.000, p=0.000), as did heart rate (p=0.000, p=0.000), oxygen haemoglobin saturation (p=0.021, p=0.012) and NIPS (p=0.000, p=0.00) and NPASS scores (p=0.000, p=0.000). The respiratory rate did not change significantly throughout the experiment (p=0.098). The NPASS scale had the largest area under the ROC curve at 0.987 95% CI [0.969, 1] and the smallest number of peaks per second at 0.869 95% CI [0.780, 0.958]. Conclusions: Skin conductance changes correlate well with changes in physiological parameters and pain scale scores. Methods of measuring pain response predict the pain stimulus with varying degrees of accuracy.
PubDate: 2023-02-28
DOI: 10.6016/ZdravVestn.3343
Issue No: Vol. 92, No. 1-2 (2023)
- Molecular links between circadian rhythm and micro RNA in hepatocellular
carcinoma
Authors: Rok Struna, Jan Tehovnik, Rok Razpotnik, Tadeja Režen
Pages: 11 - 19
Abstract: Background: Circadian rhythm is regulated at the central as well as at the cellular level via transcriptional-translational feedback loops that are precisely regulated. MiRNA molecules also affect the regulation of circadian rhythm, which, together with protein complexes, lead to the silencing of the translation of certain cellular proteins. Chronic disturbance in circadian rhythm can potentially lead to malignant cell transformation. Hepatocellular carcinoma is one of the most common cancers in humans, where the influence of different signaling pathways on carcinogenesis is still unclear. We were interested in the influence of circadian rhythm and miRNA molecules on the occurrence of hepatocellular carcinoma. We focused on the influence of circadian rhythm and miRNA molecules on circular RNA expression. We also wanted to examine whether the increased expression of specific miRNA molecules affects the amount of mRNA produced for certain proteins in liver cancer cells. Methods: The experiment was performed on the Hep G2 and Huh7 cell lines. Initially, we introduced the desired molecules (hsa-miR-17 and circadian transcription factors) into the cells by the transfection process, with which we wanted to influence the expression of the genes of interest. RNA was isolated from the cells and transcribed into complementary DNA. qPCR (quantitative polymerase chain reaction) was performed, based on which we then inferred the level of expression of the desired genes. The results were processed and presented graphically. Results: By processing the results, we found that none of the three hypotheses could be confirmed, as no statistically significant difference was found in any of the expression levels of the desired genes (α= 0.05). Conclusions: Although we could not confirm the hypotheses, the research area would be worth further attention to show a more substantial influence of the factors we observed. It would be necessary to focus on specific molecules, thus gaining new targets for treating liver diseases, which would improve the patients’ quality of life and prolong their expected survival. New risk factors could also be identified to raise public awareness of prevention to reduce the incidence of HCC.
PubDate: 2023-02-28
DOI: 10.6016/ZdravVestn.3350
Issue No: Vol. 92, No. 1-2 (2023)
- The size of extracellular vesicles correlates to the overall survival of
patients with pancreatic adenocarcinoma
Authors: Janja Smolar, Blažka Šturm, David Badovinac, Teja Lavrin, Katja Goričar, Vita Dolžan, Aleš Tomažič, Metka Lenassi
Pages: 20 - 30
Abstract: Background: Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest cancers. In our study, we wanted to evaluate the correlation between extracellular vesicles (EV) from blood plasma and the overall survival rate of patients with PDAC who were treated surgically. Methods: The retrospective study included 32 subjects diagnosed with PDAC and treated surgically at the Clinical Department of Abdominal Surgery, UMC Ljubljana. For the study, we obtained clinical data, laboratory parameters, histopathologic evaluation, and blood plasma for each subject. EVs were isolated from blood plasma and characterized for their concentration and size. Results: According to the type of surgery, the subjects were divided into two groups, i.e., those with tumour resection and those with exploration without resection. We showed that EVs in the blood plasma of subjects with exploration were significantly larger than EVs of patients with resection (p < 0.05). With the help of ROC analysis, we successfully determined the EV size cut-off value, which separated subjects according to the type of surgical treatment. At a cut-off value of 183.3 nm for mean EV size, sensitivity and specificity for resection prediction are 0.591 and 0.900, respectively, with area under the curve 0.77 (95% CI = 0.60–0.93, p = 0.016). Subjects with larger EVs had poorer overall survival (p < 0.05), whereas the survival of subjects with the average size or median size of EVs greater than the cut-off value had 13.8 months shorter overall survival (p < 0.05). Conclusion: As part of the research, we demonstrated a correlation between EV size and the overall survival of patients with PDAC who were treated surgically. We thereby demonstrated the potential of EVs as additional biomarkers for a personalized approach to treating patients with PDAC.
PubDate: 2023-02-28
DOI: 10.6016/ZdravVestn.3360
Issue No: Vol. 92, No. 1-2 (2023)
- The role of right heart catheterisation in diagnosis and treatment of
pulmonary hypertension – overview and experiences from Department for
pulmonary diseases and allergy, University Medical Centre Ljubljana
Authors: Polona Mlakar, David Lestan Urban, Barbara Salobir
Pages: 31 - 42
Abstract: Right heart catheterisation is crucial for confirming the diagnosis of pulmonary hypertension, especially in more rare disease subclasses. Right heart catheterisation enables us to measure pressure in pulmonary arteries, define hemodinamics and wedge pressure, which helps us differentiate between precapillary and postcapillary pulmonary hypertension. Furthermore, we perform vasoreactivity testing and fluid challenge testing during right heart catheterisation in selected subsets of patients. Although echocardiography is much more accessible and less invasive investigation, it can only serve us with probability of existence of pulmonary hypertension, yet we always need right heart catheterisation to confirm the diagnosis. Pulmonary hypertension covers a broad spectrum of disease subclasses, which are linked to various ilnesses, most commonly left heart disease and pulmonary diseases. Rare disease subclasses are pulmonary arterial hypertension and chronic thrombembolic pulmonary hypertension. These subclasses are effectively treated with pulmonary hypertension specific drugs and specific procedures such as pulmonary endarterectomy or pulmonary baloon angioplasty when indicated in chronic thrombembolic pulmonary hypertension, which all drastically improve prognosis and quality of patients’ life. Therefore, the diagnosis must be set firmly, always with the use of right heart catheterisation. In september 2018 we started to weekly perform right heart cateterisations at the Department for Pulmonary diseases and Allergy, University Medical Centre Ljubljana, for diagnosing and follow up of patients with rare sublclasses of pulmonary hypertension and prior to listing patients for lung transplantation.
PubDate: 2023-02-28
DOI: 10.6016/ZdravVestn.3330
Issue No: Vol. 92, No. 1-2 (2023)
- Targeted prophylaxis in RhD-negative pregnant women with anti-D
immunoglobulin in the 28th week of pregnancy in northeastern Slovenia
Authors: Natalija Lehner, Irena Bricl, Bojana Bizjak
Pages: 43 - 51
Abstract: Targeted protection is a program that allows noninvasive determination of the fetal RHD genotype from the peripheral blood of an RhD-negative pregnant woman based on a screening test. Prior to the introduction of predicted RhD phenotyping, all RhD-negative pregnant women received protection with anti-D immunoglobulin at 28 to 30 weeks of pregnancy. In Europe, 40% of RhD-negative pregnant women carry an RhD negative foetus and do not develop D antigen sensitization. With the introduction of mentioned test pregnant women receive immunoglobulin anti-D targeted protection according to the predicted foetal RhD phenotype. With the introduction of the national programme Slovenia has become one of the few countries worldwide implementing targeted protection with anti-D immunoglobulin.
PubDate: 2023-02-28
DOI: 10.6016/ZdravVestn.3336
Issue No: Vol. 92, No. 1-2 (2023)
- Case report of an adolescent girl with pulmonary embolism
Authors: Tjaša Ribič Senica, Saša Ilovar, Andraž Zupan, Barbara Salobir
Pages: 52 - 58
Abstract: Pulmonary embolism is very rare in the paediatric and teenage population and is frequently diagnosed with delay due to its diverse clinical presentation. Scoring systems, like The Wells and Geneva Score, are commonly used in adults to exclude or suspect the diagnosis of pulmonary embolism; however, they have not proven reliable in children and teenagers. Therefore, it is important to recognize the signs and consider pulmonary embolism among differential diagnoses in a child or adolescent with dyspnea, tachypnea, tachycardia, chest pain, and cough, especially if they have risk factors for venous thromboembolism. Moreover, knowledge about risk factors in different age groups is increasing and can help us with the diagnosis. In the following paper, we present a case of a 17-year-old girl with pulmonary embolism in whom the diagnosis was delayed despite a clear trigger – oral hormonal contraception. We want to raise awareness of pulmonary embolism in teenage girls using oral hormonal contraception and increase doctors’ perceptionof this pathology in adolescents.
PubDate: 2023-02-28
DOI: 10.6016/ZdravVestn.3344
Issue No: Vol. 92, No. 1-2 (2023)
- Liquid biopsy – a diagnostic and therapeutic tool in the treatment of
non-small cell lung cancer
Authors: Maša Majcen, Aleš Rozman, Izidor Kern; prim.
Pages: 59 - 69
Abstract: Lung cancer is one of the most prevalent cancers and the leading cause of cancer mortality worldwide. The past decade has brought important progress in drug treatments by discovering the driver mutations. The evolution of targeted oncological treatments directed to the biological properties of lung cancer in the individual patient has led to a significant increase in survival. During treatment, new mutations accumulate in the tumour, which prevents the long-term success of the therapy. Liquid biopsy is a method that has established itself in recent years as a less invasive diagnostic procedure that allows monitoring the response to treatment and identifying the mechanisms of resistance. The circulating tumor DNA is the most prevalent biomarker in lung cancer, but research on other biomarkers is also active. In this review article, we present the use of liquid biopsy in the clinical treatment of patients with non-small cell lung cancer. Its use is increasingly recognized in early detection of lung cancer, identifying resistant mutations, potential assessment of disease burden, and longitudinal monitoring.
PubDate: 2023-02-28
DOI: 10.6016/ZdravVestn.3294
Issue No: Vol. 92, No. 1-2 (2023)
- Recognition and management of obstetric anal sphincter injuries
Authors: Tamara Serdinšek, Gregor Prša, Ivan Žebeljan
Pages: 70 - 78
Abstract: More than 85% of women experience some degree of perineal trauma during vaginal delivery, and obstetric anal sphincter injuries occur in 0.5-7% of all vaginal deliveries. Up to 20-40% of obstetric anal sphincter injuries are either occult or missed, so it is of uttermost importance to recognize them properly. In case of obstetric anal sphincter injury, it is advisable to perform the repair in the surgical theatre. Before repair, it is necessary to examine the tear under adequate lighting and analgesia. Anorectal mucosa is sutured with either interrupted or continuous sutures, while the internal anal sphincter can be sutured with either interrupted or mattress sutures. For injuries of the external anal sphincter involving the full length and thickness of the muscle, either the end-to-end suture technique or the overlap technique can be used, or the end-to-end technique for partial injuries. In the end, perineal muscles and skin are sutured. Antibiotic prophylaxis and laxatives are used in the perioperative period. Patient follow-up is required for the first time in 6-12 weeks after delivery. Among the most common consequences of obstetric anal sphincter injuries are perineal pain and dyspareunia, negative impact on sexual life, and anal incontinence, which occurs in 15-61% of all cases. Women also need to be counselled regarding the mode of delivery in the subsequent pregnancy, as a risk for another obstetric anal sphincter injury in the subsequent delivery is 4-8%.
PubDate: 2023-02-28
DOI: 10.6016/ZdravVestn.3329
Issue No: Vol. 92, No. 1-2 (2023)
- Challenges and modern approaches to the treatment of atopic dermatitis
Authors: Mercedes Vitek, Alenka Zvonar Pobirk, Mirjana Gašperlin, Mirjam Gosenca Matjaž
Pages: 79 - 92
Abstract: Atopic dermatitis is the most common chronic inflammatory skin disease, characterized by changes in skin structure manifesting through red, dry and scaly areas accompanied by itching. Due to its complexity, the disease represents a considerable therapeutic challenge. Thus, up-to-date treatment guidelines emphasise the importance of comprehensive treatment. Regular and proper skincare with cosmetic products containing active ingredients that restore impaired skin barrier function through various mechanisms is of great importance. Further, depending on the degree of inflammation and the extent of skin lesions, drugs for local or systemic treatment are required. According to the standard therapeutic modalities, drugs for local therapy are used as long as the patient responds. Typically, active ingredients for dermal administration intended for active skincare and/or therapy are incorporated into conventional dosage forms such as ointments, creams, dermal solutions, and emulsions. However, in recent years major advances have been made toward developing innovative lipid-based delivery systems, such as lyotropic liquid crystals, micro- and nano-emulsions, vesicular systems, and lipid nanoparticles. The present paper systematically reviews active ingredients for skincare of atopic skin along with drugs and dosage forms registered in Slovenia for the treatment of atopic dermatitis . Concurrently, attractive scientific researches, patent publications and new achievements in innovative lipid-based delivery systems are presented, proving their unique advantages that enable patient-friendly treatment and improved therapeutic outcomes.
PubDate: 2023-02-28
DOI: 10.6016/ZdravVestn.3331
Issue No: Vol. 92, No. 1-2 (2023)
- Development of slovene medical periodical press
Authors: Dušan Sket
Pages: 93 - 97
Abstract: Slovene medical periodical publishing started in 1909 with the agreement between the »Society of Physicians in Carniola« and the »Society of Physicians of the Kingdom of Croatia-Slavonia«. The agreement enabled Slovenian physicians to publish their articles in the Croatian journal Liječnički vjesnik in the Slovene language. Liječnički vjesnik was an essential catalyst for developing the Slovene medical language and press. From 1909 to 1929, when the Slovenian journal Zdravniški vestnik started, 105 professional articles were published in Liječnički vjesnik. With the appearance of the new Slovenian journal, the publishing in Liječnički vjesnik markedly declined.
PubDate: 2023-02-28
DOI: 10.6016/ZdravVestn.3376
Issue No: Vol. 92, No. 1-2 (2023)
- Corrigendum
Authors: Matevž Harlander, David Lestan, Matjaž Turel, Mojca Drnovšek Globokar, Elizabeta Špela Mušič, Dejan Pirc, Suada Fileković Ribarič, Michael Gradišek, Boris Greif, Peter Jaksch, Walter Klepetko, Tomaž Štupnik
Pages: 98 - 98
Abstract: No abstract.
PubDate: 2023-02-28
DOI: 10.6016/ZdravVestn.3421
Issue No: Vol. 92, No. 1-2 (2023)
