Caring for victims of sexual assault demands of the physician a precise physical examination, provision of evidence, psychological support and appropriate treatment. Because the majority of victims of sexual violence are women, we usually encounter these patients in gynecological clinics. If the evidence is collected and stored properly, with special forensic methods we can distinguish between any two persons in the world, except identical twins. Therefore, patient’s history and taking evidence is of utmost importance. In the case of sexual assault, infection with sexually transmitted diseases is possible, so they should be diagnosed and treated in time. The victim should be offered the use of emergency contraception, which is only effective in the first days after sexual assault. To make sure that each step of the examination is completed and all samplings are done in the correct order, it is useful to have a written questionnaire or a routine protocol. We describe stepby- step management procedures for victims of sexual assault, taking into consideration the victim’s history, physical examination, different samplings, and different emergency treatments.
{"title":"Questionnaire for the management of the victim of sexual abuse","authors":"I. Takač, T. Bizjak, D. Arko","doi":"10.6016/1888","DOIUrl":"https://doi.org/10.6016/1888","url":null,"abstract":"Caring for victims of sexual assault demands of the physician a precise physical examination, provision of evidence, psychological support and appropriate treatment. Because the majority of victims of sexual violence are women, we usually encounter these patients in gynecological clinics. If the evidence is collected and stored properly, with special forensic methods we can distinguish between any two persons in the world, except identical twins. Therefore, patient’s history and taking evidence is of utmost importance. In the case of sexual assault, infection with sexually transmitted diseases is possible, so they should be diagnosed and treated in time. The victim should be offered the use of emergency contraception, which is only effective in the first days after sexual assault. To make sure that each step of the examination is completed and all samplings are done in the correct order, it is useful to have a written questionnaire or a routine protocol. We describe stepby- step management procedures for victims of sexual assault, taking into consideration the victim’s history, physical examination, different samplings, and different emergency treatments.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"23 1","pages":"326-338"},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83639052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: In cases of normotensive patients, hypokalemia with metabolic alkalosis is most frequently caused by repeated vomiting or diuretics abuse, and rarely by tubulopathies, e.g., Bartter or Gitelman syndrome (GS). Case report: An adolescent girl who was repeatedly examined due to collapses and cramps in the hands. A characteristic set of metabolic abnormalities for tubulopathies was discovered in an acute stress situation with inapetence. Proper diet and supplementation with potassium and magnesium was needed for maintaining electrolyte balance of the patient. Conclusions: In cases of unexplained hypokalemia and metabolic alkalosis associated with a normal or low blood pressure a tubulopathy, e.g., Gitelman syndrome, must be excluded. The identification and recognition of correct diagnosis is extremely important since a proper treatment can reduce the risk of life-threatening events, e.g. arrhythmias.
{"title":"Girl with hypokaliemia and metabolic alkalosis: a case report.","authors":"Ksenja Marguč Kirn, M. A. Stefanija, R. Rus","doi":"10.6016/1855","DOIUrl":"https://doi.org/10.6016/1855","url":null,"abstract":"Background: In cases of normotensive patients, hypokalemia with metabolic alkalosis is most frequently caused by repeated vomiting or diuretics abuse, and rarely by tubulopathies, e.g., Bartter or Gitelman syndrome (GS).\u0000Case report: An adolescent girl who was repeatedly examined due to collapses and cramps in the hands. A characteristic set of metabolic abnormalities for tubulopathies was discovered in an acute stress situation with inapetence. Proper diet and supplementation with potassium and magnesium was needed for maintaining electrolyte balance of the patient.\u0000Conclusions: In cases of unexplained hypokalemia and metabolic alkalosis associated with a normal or low blood pressure a tubulopathy, e.g., Gitelman syndrome, must be excluded. The identification and recognition of correct diagnosis is extremely important since a proper treatment can reduce the risk of life-threatening events, e.g. arrhythmias.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"35 1","pages":"273-276"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86484403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Communicating with patients is a basic skill of a family doctor. It includes taking the history while following the patient’s feelings and expectations and explaining the intended tests and treatment. Good communication between the doctor and the patient enables maintaining their long-term quality relationship based on trust. Such a relationship significantly contributes to the quality of medical care of the patient and brings satisfaction not only to the patient but also to the entire medical staff involved in the treatment. Communication skills can be learned. But teaching such communication in the classic medical education has long been neglected. The Department of Family medicine at the Medical Faculty of Ljubljana has contributed considerably to some changes in this area. Results of several researches have shown that changes in learning communication skills cannot be made by simply learning from books or attending lectures. Therefore, the Department of Family medicine has been enabling their students to improve their skills of communication through different forms of practical work for 15 years. The purpose of this article is to present 15 years of experience in teaching communication especially with the help of video at the Department of Family Medicine at the Medical Faculty of Ljubljana.
{"title":"Teaching communication with the help of video and simulated patients - 15 years of experience of the medical faculty of Ljubljana.","authors":"Anja Zidanšek, J. Rifel, I. Švab","doi":"10.6016/1794","DOIUrl":"https://doi.org/10.6016/1794","url":null,"abstract":"Communicating with patients is a basic skill of a family doctor. It includes taking the history while following the patient’s feelings and expectations and explaining the intended tests and treatment. Good communication between the doctor and the patient enables maintaining their long-term quality relationship based on trust. Such a relationship significantly contributes to the quality of medical care of the patient and brings satisfaction not only to the patient but also to the entire medical staff involved in the treatment. Communication skills can be learned. But teaching such communication in the classic medical education has long been neglected. The Department of Family medicine at the Medical Faculty of Ljubljana has contributed considerably to some changes in this area. Results of several researches have shown that changes in learning communication skills cannot be made by simply learning from books or attending lectures. Therefore, the Department of Family medicine has been enabling their students to improve their skills of communication through different forms of practical work for 15 years. The purpose of this article is to present 15 years of experience in teaching communication especially with the help of video at the Department of Family Medicine at the Medical Faculty of Ljubljana.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"68 1","pages":"192-199"},"PeriodicalIF":0.0,"publicationDate":"2013-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88792517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mateja Obrez, H. Motaln, Urška Tajnšek, T. Turnšek
The concepts of tumour origin and stochastic nature of carcinogenesis are being challenged today by hierarchical models that predict the existence of cancer stem cells (CSCs), which are postulated as unique cell population capable of infinite self renewal, multilineage differentiation and having a higher resistance to conventional cancer therapy thus facilitating malignant growth and therapy resistance. Accordingly, successful treatment of adult brain tumour–glioma and its most malignant stage–glioblastoma multiforme (GBM), would require the elimination of CSCs to avoid tumour relapse. Yet, with available therapy (i.e. surgery) in GBMs this cannot be achieved, due to infiltrative growth of a subpopluation of GBM cells with highly expressed migratory genes (migratome) into the normal brain tissue.Besides CSCs – a proven prerequisite for tumour development and progression, tumour bulk mass also comprises haematopoietic stem cells, endothelial progenitor cells and mesenchymal stem cells (MSCs). The role of these other types of stem cell was shown to largely depend on the tumour microenvironment, where their contradictory anti-tumour action was evidenced. Yet, the exact mechanisms and MSC’s role in cell-mediated modulation of tumour behaviour via paracrine and direct interactions with GBM (stem) cells still remain unknown. Nevertheless these stem cells, particularly MSCs, may represent novel therapeutic vectors for enhanced target-site delivery of chemotherapeutics, which are urgently needed to improve efficiency of current glioma treatment. So far, cell therapy using MSCs appears promising, due to MSC’s selective tumour tropism and their immuno-modulatory potential regarding treatment of GBM, which will be discussed in this review.
{"title":"The role of stem cells in glioma progression and therapy","authors":"Mateja Obrez, H. Motaln, Urška Tajnšek, T. Turnšek","doi":"10.6016/1753","DOIUrl":"https://doi.org/10.6016/1753","url":null,"abstract":"The concepts of tumour origin and stochastic nature of carcinogenesis are being challenged today by hierarchical models that predict the existence of cancer stem cells (CSCs), which are postulated as unique cell population capable of infinite self renewal, multilineage differentiation and having a higher resistance to conventional cancer therapy thus facilitating malignant growth and therapy resistance. Accordingly, successful treatment of adult brain tumour–glioma and its most malignant stage–glioblastoma multiforme (GBM), would require the elimination of CSCs to avoid tumour relapse. Yet, with available therapy (i.e. surgery) in GBMs this cannot be achieved, due to infiltrative growth of a subpopluation of GBM cells with highly expressed migratory genes (migratome) into the normal brain tissue.Besides CSCs – a proven prerequisite for tumour development and progression, tumour bulk mass also comprises haematopoietic stem cells, endothelial progenitor cells and mesenchymal stem cells (MSCs). The role of these other types of stem cell was shown to largely depend on the tumour microenvironment, where their contradictory anti-tumour action was evidenced. Yet, the exact mechanisms and MSC’s role in cell-mediated modulation of tumour behaviour via paracrine and direct interactions with GBM (stem) cells still remain unknown. Nevertheless these stem cells, particularly MSCs, may represent novel therapeutic vectors for enhanced target-site delivery of chemotherapeutics, which are urgently needed to improve efficiency of current glioma treatment. So far, cell therapy using MSCs appears promising, due to MSC’s selective tumour tropism and their immuno-modulatory potential regarding treatment of GBM, which will be discussed in this review.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"56 1","pages":"113-122"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87037709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Penicillin antibiotics are the most common medicines that are suspected to cause allergy. True penicillin allergy is rarely diagnosed in clinical practice. Many patients with a personal history of penicillin allergy are unnecessarily denied the benefits of penicillin and are given broader-spectrum antibiotics. Such unnecessary prescription of extended-spectrum antibiotics could contribute to the development and spread of multiple drug-resistant bacteria. The aim of our study was to check the identification and treatment of patients with a reported history of penicillin allergy. Methods: In the first part of the study, 21 pharmacies were included. Pharmacists asked adults who came to the pharmacy with a prescription for a non-penicillin antibiotic whether they are penicillin allergic and whether the allergy was confirmed with tests. In the second part of the study the antibiotic prescription pattern was surveyed in patients with ruled-out penicillin allergy. Results: 355/435 (81.6%) subjects, who came with the prescriptions for non-penicillin antibiotic, were patients – direct users of the prescribed antibiotic. Out of 124 patients with non-penicillin prescriptions, 26 (21%) claimed penicillin hypersensitivity, however, only in 7 (26.9%) it had been confirmed by allergy tests. Out of 272 patients with presumed penicillin hypersensitivity, diagnosis was confirmed in only 22 (8%). 61.4% patients with ruled-out penicillin allergy got a prescription for antibiotic in the previous year. However, in only 43.9% of cases these were penicillin antibiotics. Conclusion: We confirmed that many patients report penicillin allergy, however, the allergy is rarely confirmed by tests. Also, after tests that rule out penicillin allergy have been performed, penicillin antibiotics are still prescribed in lesser percent than other antibiotics. We found out that the vast majority of adults who come in the pharmacy with an antibiotic prescription are direct consumers of the prescribed antibiotic. Therefore, there is an opportunity to develop and implement a program of pharmaceutical care also for antibiotic treatment.
{"title":"Identification and treatment of patients with suspected penicillin allergy.","authors":"Mateja Grošelj, A. Mrhar, M. Zidarn, M. Košnik","doi":"10.6016/1748","DOIUrl":"https://doi.org/10.6016/1748","url":null,"abstract":"Background: Penicillin antibiotics are the most common medicines that are suspected to cause allergy. True penicillin allergy is rarely diagnosed in clinical practice. Many patients with a personal history of penicillin allergy are unnecessarily denied the benefits of penicillin and are given broader-spectrum antibiotics. Such unnecessary prescription of extended-spectrum antibiotics could contribute to the development and spread of multiple drug-resistant bacteria. The aim of our study was to check the identification and treatment of patients with a reported history of penicillin allergy.\u0000Methods: In the first part of the study, 21 pharmacies were included. Pharmacists asked adults who came to the pharmacy with a prescription for a non-penicillin antibiotic whether they are penicillin allergic and whether the allergy was confirmed with tests. In the second part of the study the antibiotic prescription pattern was surveyed in patients with ruled-out penicillin allergy.\u0000Results: 355/435 (81.6%) subjects, who came with the prescriptions for non-penicillin antibiotic, were patients – direct users of the prescribed antibiotic. Out of 124 patients with non-penicillin prescriptions, 26 (21%) claimed penicillin hypersensitivity, however, only in 7 (26.9%) it had been confirmed by allergy tests. Out of 272 patients with presumed penicillin hypersensitivity, diagnosis was confirmed in only 22 (8%). 61.4% patients with ruled-out penicillin allergy got a prescription for antibiotic in the previous year. However, in only 43.9% of cases these were penicillin antibiotics.\u0000Conclusion: We confirmed that many patients report penicillin allergy, however, the allergy is rarely confirmed by tests. Also, after tests that rule out penicillin allergy have been performed, penicillin antibiotics are still prescribed in lesser percent than other antibiotics. We found out that the vast majority of adults who come in the pharmacy with an antibiotic prescription are direct consumers of the prescribed antibiotic. Therefore, there is an opportunity to develop and implement a program of pharmaceutical care also for antibiotic treatment.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"92 1","pages":"80-85"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87744156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Backg round: Preimplantation genetic diagnosis (PGD) is used to analyze embryos before their transfer into uterus. It is suitable for a group of patients who are at a substantial risk of conceiving a pregnancy affected by a known genetic defect. PGD requires medically assisted reproduction, embryo biopsy of one or two cells and genetic analysis using either fluorescent in situ hybridization (FISH) or polymerase chain reaction. New technologies for PGD are now emerging. Array-based technologies allow simultaneous testing of aneuploidy and specific genetic diseases in each embryo. The main indications for PGD have been single gene disorders and in-herited chromosomal abnormalities. Preimplantation genetic screening (PGS) was introduced for aneuploidy screening, with the aim of replacing euploid embryos and increasing pregnancy rates in certain groups of patients undergoing in vitro fertilization procedures owing to infertility. Lately, several randomized control trials have failed to show that PGS on blastomeres using FISH method improved the delivery rate compared to the control group. The main reason is probably the natural occurrence of chromosomal mosaicism in the cleavage-stage embryo. Conclusions: Over the last two decades, PGD has been shown to be a reliable and safe genetic test for couples who are at risk of a specific inher - ited disorder. For PGS, the results from several ongoing randomized controlled trials performed at different cell biopsy stage, using array-CGH and SNP array will provide the data needed to evaluate the clinical efficacy.
{"title":"Preimplantation genetic diagnosis.","authors":"K. Writzl","doi":"10.6016/1752","DOIUrl":"https://doi.org/10.6016/1752","url":null,"abstract":"Backg round: Preimplantation genetic diagnosis (PGD) is used to analyze embryos before their transfer into uterus. It is suitable for a group of patients who are at a substantial risk of conceiving a pregnancy affected by a known genetic defect. PGD requires medically assisted reproduction, embryo biopsy of one or two cells and genetic analysis using either fluorescent in situ hybridization (FISH) or polymerase chain reaction. New technologies for PGD are now emerging. Array-based technologies allow simultaneous testing of aneuploidy and specific genetic diseases in each embryo. The main indications for PGD have been single gene disorders and in-herited chromosomal abnormalities. Preimplantation genetic screening (PGS) was introduced for aneuploidy screening, with the aim of replacing euploid embryos and increasing pregnancy rates in certain groups of patients undergoing in vitro fertilization procedures owing to infertility. Lately, several randomized control trials have failed to show that PGS on blastomeres using FISH method improved the delivery rate compared to the control group. The main reason is probably the natural occurrence of chromosomal mosaicism in the cleavage-stage embryo.\u0000Conclusions: Over the last two decades, PGD has been shown to be a reliable and safe genetic test for couples who are at risk of a specific inher - ited disorder. For PGS, the results from several ongoing randomized controlled trials performed at different cell biopsy stage, using array-CGH and SNP array will provide the data needed to evaluate the clinical efficacy.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"5 1","pages":"106-112"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74161189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.6016/slovmedjour.v82i12.1031
Č. Oblak, P. Jevnikar, T. Kosmač
Background : A group of inorganic non-metal biomaterials, that are commonly used in clinical medicine to replace or repair tissues, can be classified as a bioceramics. This group includes bioactive glasses, glass-ceramics, hydroxy-apatite and some other calcium phosphates. In addition, some bio-inert engineering ceramics materials have become increasingly utilised, aluminum oxide, zirconium oxide and their composites being the most popular. With the developement of yttria stabilized tetragonal zirconium oxide ceramics (Y-TZP) medical community received a high strength biomaterial that is currently a material of choice for the manufacturing of medical devices. Y-TZP ceramics is becoming also increasingly used in dental medicine, where frameworks are manufactured by the use of computer-assisted technology. Conclusions : The article describes the basic properties of zirconia oxide ceramics important for the use in clinical medicine; high strength and fracture toughness, biocompatibility and negligible radiation. The ageing issue of this particular material, which is attributable to the thermo-dynamical instability of tetragonal zirconium oxide in hydrothermal conditions, is also discussed. When exposed to an aqueous environment over long periods of time, the surface of the Y-TZP ceramic will start transforming spontaneously into the monoclinic structure. The mechanism leading to the t-m transformation is temperature-dependent and is accompanied by extensive micro-cracking, which ultimately leads to strength degradation. The degradation might influence the clinical success rate of medical devices and therefore Y-TZP femoral heads are no longer made of pure zirconium oxide. Composites of zirconium and aluminium oxides are used instead, that are currently the strongest ceramic materials used in clinical medicine. In this work the clinical application of zirconia oxide ceramics in dental medicine is also presented. Conventional porcelain fused to metal technique is successfully replaced with Y-TZP ceramics in some clinical situations that are described in detail. It is important that computer design of the zirconia frameworks shortens and simplifies laboratory procedures and contributes to a precise final product.
{"title":"Properties and clinical application of zirconia bioceramics in medicine.","authors":"Č. Oblak, P. Jevnikar, T. Kosmač","doi":"10.6016/slovmedjour.v82i12.1031","DOIUrl":"https://doi.org/10.6016/slovmedjour.v82i12.1031","url":null,"abstract":"Background : A group of inorganic non-metal biomaterials, that are commonly used in clinical medicine to replace or repair tissues, can be classified as a bioceramics. This group includes bioactive glasses, glass-ceramics, hydroxy-apatite and some other calcium phosphates. In addition, some bio-inert engineering ceramics materials have become increasingly utilised, aluminum oxide, zirconium oxide and their composites being the most popular. With the developement of yttria stabilized tetragonal zirconium oxide ceramics (Y-TZP) medical community received a high strength biomaterial that is currently a material of choice for the manufacturing of medical devices. Y-TZP ceramics is becoming also increasingly used in dental medicine, where frameworks are manufactured by the use of computer-assisted technology. Conclusions : The article describes the basic properties of zirconia oxide ceramics important for the use in clinical medicine; high strength and fracture toughness, biocompatibility and negligible radiation. The ageing issue of this particular material, which is attributable to the thermo-dynamical instability of tetragonal zirconium oxide in hydrothermal conditions, is also discussed. When exposed to an aqueous environment over long periods of time, the surface of the Y-TZP ceramic will start transforming spontaneously into the monoclinic structure. The mechanism leading to the t-m transformation is temperature-dependent and is accompanied by extensive micro-cracking, which ultimately leads to strength degradation. The degradation might influence the clinical success rate of medical devices and therefore Y-TZP femoral heads are no longer made of pure zirconium oxide. Composites of zirconium and aluminium oxides are used instead, that are currently the strongest ceramic materials used in clinical medicine. In this work the clinical application of zirconia oxide ceramics in dental medicine is also presented. Conventional porcelain fused to metal technique is successfully replaced with Y-TZP ceramics in some clinical situations that are described in detail. It is important that computer design of the zirconia frameworks shortens and simplifies laboratory procedures and contributes to a precise final product.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"25 1","pages":"825-836"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85985641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: In the last years, an important development in the diagnostic procedures and treatment of venous disease of the lower limbs has been achieved. Due to the lack of anatomic names for some of the clinically relevant veins, different clinical eponyms were introduced. Recently, an international consensus on the nomenclature of leg veins was accepted to simplify the communication and to minimize the risk of mistreatment. Authors of this article reviewed new literature on he veins of the lower limbs and compared the new terminology with the old one. Conclusions: Through the systematic review of superficial, deep and perforant veins, authors point out the altered and newly introduced names of the veins. The majority of changes refer to the names of superficial veins and perforators. The use of clinical eponyms is discouraged and descriptive terms designating location of the veins are preferred instead. The nomenclature of the deep veins has not been changed much. The term deep femoral vein, already in use in clinical practice was introduced, whereas the use of clinical term superficial femoral vein was discouraged. The most important changes in vein nomenclature are summarized in the table.
{"title":"Veins of the lower limbs - anatomy and new terminology.","authors":"Anja Boc, V. Čebašek","doi":"10.6016/1690","DOIUrl":"https://doi.org/10.6016/1690","url":null,"abstract":"Background: In the last years, an important development in the diagnostic procedures and treatment of venous disease of the lower limbs has been achieved. Due to the lack of anatomic names for some of the clinically relevant veins, different clinical eponyms were introduced. Recently, an international consensus on the nomenclature of leg veins was accepted to simplify the communication and to minimize the risk of mistreatment. Authors of this article reviewed new literature on he veins of the lower limbs and compared the new terminology with the old one. Conclusions: Through the systematic review of superficial, deep and perforant veins, authors point out the altered and newly introduced names of the veins. The majority of changes refer to the names of superficial veins and perforators. The use of clinical eponyms is discouraged and descriptive terms designating location of the veins are preferred instead. The nomenclature of the deep veins has not been changed much. The term deep femoral vein, already in use in clinical practice was introduced, whereas the use of clinical term superficial femoral vein was discouraged. The most important changes in vein nomenclature are summarized in the table.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"17 1","pages":"31-40"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76049869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Dendritic cells (DCs) are considered as primary carriers of antigenic (Ag) information in the human body. This information is later presented to Ag-specific T lymphocytes in various ways that can be either immunostimulating or immunosuppressive. The latter depends on the activation status of DCs, in which way the DCs display extreme plasticity in terms of their function. Tolerogenic DCs, which are characterized by extensive immunosuppressive properties, can induce the generation of regulatory T lymphocytes or cause T-cell anergy. In the last two decades, considerable evidence has accumulated using animal models, which points to safety and efficacy of DC application in terms of treating immune-mediated diseases. Immuntherapy using DCs is nowadays becoming a clinical reality. At present, a clinical study using autologous DCs derived from human monocytes and treated ex vivo to induce their immunosuppressive potential, with the aim to treat autoimmune type 1 diabetes, is registered within NIH (National Institutes of Health). Conclusion: The review discusses the characteristics of DCs, suitable for use in cellular therapy of autoimmune diseases, their role in such therapies and the way in which such cells can be generated in the laboratory. Therapy of autoimmune diseases using tolerogenic DCs represents an outstanding potential, however the major obstacles lay in the way of proper preparation of cellular products, where all procedures should follow the strict demands of good manufacturing practice (GMP).
{"title":"Tolerogenic dendritic cell therapy – causal treatment of autoimmune diseases","authors":"U. Švajger, M. Jeras","doi":"10.6016/1692","DOIUrl":"https://doi.org/10.6016/1692","url":null,"abstract":"Background: Dendritic cells (DCs) are considered as primary carriers of antigenic (Ag) information in the human body. This information is later presented to Ag-specific T lymphocytes in various ways that can be either immunostimulating or immunosuppressive. The latter depends on the activation status of DCs, in which way the DCs display extreme plasticity in terms of their function. Tolerogenic DCs, which are characterized by extensive immunosuppressive properties, can induce the generation of regulatory T lymphocytes or cause T-cell anergy. In the last two decades, considerable evidence has accumulated using animal models, which points to safety and efficacy of DC application in terms of treating immune-mediated diseases. Immuntherapy using DCs is nowadays becoming a clinical reality. At present, a clinical study using autologous DCs derived from human monocytes and treated ex vivo to induce their immunosuppressive potential, with the aim to treat autoimmune type 1 diabetes, is registered within NIH (National Institutes of Health). Conclusion: The review discusses the characteristics of DCs, suitable for use in cellular therapy of autoimmune diseases, their role in such therapies and the way in which such cells can be generated in the laboratory. Therapy of autoimmune diseases using tolerogenic DCs represents an outstanding potential, however the major obstacles lay in the way of proper preparation of cellular products, where all procedures should follow the strict demands of good manufacturing practice (GMP).","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"7 1","pages":"47-54"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80106342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Kozel, J. Zakotnik, A. T. Grum, J. Kersnik, D. Pavlič, M. Tomori, S. Ziherl
Background: The prevalence of depression in primary care setting is high. About a half of patients with depression remain undetected. The aim of our study was to determine whether screening questionnaires assist family practitioners in identifying more patients with depression. Methods: The multicentric study included 25 medical teams (a family practitioner and a nurse) from several Slovenian regions and 2,328 patients (86 % of all patients who were asked to participate) above 18 years of age, who had not been treated for mental disorders and who during the study visited their family practitioners for different medical problems. The study was divided into two phases, which lasted three consecutive hours daily over a period of ten working days. In the first phase, the family practitioners recorded the number of new diagnoses of depression. Six weeks later, patients completed the Zung Self-Rating Depression Scale (ZSRDS) in the waiting room. At the same time, family practitioner used the Patient Health Questionnaire 9 (PHQ-9) to screen depression symptoms. Results: In the first phase, depression was diagnosed in 5.7 % participating patients, and in the second phase, 10.9 % of patients on ZSRDS or 9.6 % on PHQ-9 exceeded the cut-off score. The difference was statistically significant in ZSRDS (p < 001). Patients with positive screening results were mostly women – 16.9 % (PHQ-9) or 18.8 % (ZSRDS), and patients with chronic condition – 22.0 % (PHQ-9) or 23.3 % (ZSRDS), both in age groups from 46 to 55 years. The family practitioners treated 94.6 % (PHQ-9) or 71.3 % (ZSRDS) of people with positive screening results. Conclusions: Results of both screening questionnaires were comparable. The screening tools can help family physicians in more efficientBackground: The prevalence of depression in primary care setting is high. About a half of patients with depression remain undetected. The aim of our study was to determine whether screening questionnaires assist family practitioners in identifying more patients with depression. Methods: The multicentric study included 25 medical teams (a family practitioner and a nurse) from several Slovenian regions and 2,328 patients (86 % of all patients who were asked to participate) above 18 years of age, who had not been treated for mental disorders and who during the study visited their family practitioners for different medical problems. The study was divided into two phases, which lasted three consecutive hours daily over a period of ten working days. In the first phase, the family practitioners recorded the number of new diagnoses of depression. Six weeks later, patients completed the Zung Self-Rating Depression Scale (ZSRDS) in the waiting room. At the same time, family practitioner used the Patient Health Questionnaire 9 (PHQ-9) to screen depression symptoms. Results: In the first phase, depression was diagnosed in 5.7 % participating patients, and in the second phase, 10.9 % of patients on ZSRDS or 9.6 % on PHQ
{"title":"Applicability of systematic screening for signs and symptoms of depression in family practice patients in Slovenia.","authors":"D. Kozel, J. Zakotnik, A. T. Grum, J. Kersnik, D. Pavlič, M. Tomori, S. Ziherl","doi":"10.6016/1572","DOIUrl":"https://doi.org/10.6016/1572","url":null,"abstract":"Background: The prevalence of depression in primary care setting is high. About a half of patients with depression remain undetected. The aim of our study was to determine whether screening questionnaires assist family practitioners in identifying more patients with depression.\u0000Methods: The multicentric study included 25 medical teams (a family practitioner and a nurse) from several Slovenian regions and 2,328 patients (86 % of all patients who were asked to participate) above 18 years of age, who had not been treated for mental disorders and who during the study visited their family practitioners for different medical problems. The study was divided into two phases, which lasted three consecutive hours daily over a period of ten working days. In the first phase, the family practitioners recorded the number of new diagnoses of depression. Six weeks later, patients completed the Zung Self-Rating Depression Scale (ZSRDS) in the waiting room. At the same time, family practitioner used the Patient Health Questionnaire 9 (PHQ-9) to screen depression symptoms. \u0000Results: In the first phase, depression was diagnosed in 5.7 % participating patients, and in the second phase, 10.9 % of patients on ZSRDS or 9.6 % on PHQ-9 exceeded the cut-off score. The difference was statistically significant in ZSRDS (p < 001). Patients with positive screening results were mostly women – 16.9 % (PHQ-9) or 18.8 % (ZSRDS), and patients with chronic condition – 22.0 % (PHQ-9) or 23.3 % (ZSRDS), both in age groups from 46 to 55 years. The family practitioners treated 94.6 % (PHQ-9) or 71.3 % (ZSRDS) of people with positive screening results.\u0000Conclusions: Results of both screening questionnaires were comparable. The screening tools can help family physicians in more efficientBackground: The prevalence of depression in primary care setting is high. About a half of patients with depression remain undetected. The aim of our study was to determine whether screening questionnaires assist family practitioners in identifying more patients with depression.\u0000Methods: The multicentric study included 25 medical teams (a family practitioner and a nurse) from several Slovenian regions and 2,328 patients (86 % of all patients who were asked to participate) above 18 years of age, who had not been treated for mental disorders and who during the study visited their family practitioners for different medical problems. The study was divided into two phases, which lasted three consecutive hours daily over a period of ten working days. In the first phase, the family practitioners recorded the number of new diagnoses of depression. Six weeks later, patients completed the Zung Self-Rating Depression Scale (ZSRDS) in the waiting room. At the same time, family practitioner used the Patient Health Questionnaire 9 (PHQ-9) to screen depression symptoms.\u0000Results: In the first phase, depression was diagnosed in 5.7 % participating patients, and in the second phase, 10.9 % of patients on ZSRDS or 9.6 % on PHQ","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"47 1","pages":"838-846"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77484854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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