Background: The revised FIGO staging system for carcinoma of the vulva, cervix uteri, and endometrium, which had been previously revised in 1988, 1994, and 1988, respectively, was approved by the International Federation of Gynecology and Obstetrics (FIGO) in September 2008. In addition to the revisions of previously existing staging systems, a new staging system for uterine sarcomas was introduced at the same time.Conclusions: The changes mostly addressed the prognostic disproportions between certain (sub) stages that had been shown in numerous statistical analyses. Vulvar cancer staging has undergone the greatest changes.
{"title":"New International federation of gynecology and obstetrics (FIGO) staging system of gynecological cancers","authors":"I. Takač, Nina Fokter","doi":"10.6016/78","DOIUrl":"https://doi.org/10.6016/78","url":null,"abstract":"Background: The revised FIGO staging system for carcinoma of the vulva, cervix uteri, and endometrium, which had been previously revised in 1988, 1994, and 1988, respectively, was approved by the International Federation of Gynecology and Obstetrics (FIGO) in September 2008. In addition to the revisions of previously existing staging systems, a new staging system for uterine sarcomas was introduced at the same time.\u0000Conclusions: The changes mostly addressed the prognostic disproportions between certain (sub) stages that had been shown in numerous statistical analyses. Vulvar cancer staging has undergone the greatest changes.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"2004 1","pages":"233-239"},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82957246","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: The ivy leaf extract is a natural substance with secretolytic effect. Its efficacy and safety have been documented in several randomized, double-blind placebo-controlled trials. The aim of our study was to confirm the safety of ivy leaf extract in Slovenian children with acute inflammatory airway disease and to investigate the course of treatment.Methods: 193 children with clinical signs of acute airway disease, aged 2 to 14 years were included in a prospective postmarketing study. At the beginning of the study, 7-day treatment with syrup of ivy leaf extract was started.Results: The treatment was effective in 93.7 % of children, who showed an improvement of clinical symptoms. The proportion of children with productive cough was 43.6 % at first visit and 84.9 % at second visit. Skin allergy as a side effect was reported in one child.Conclusions: The study demonstrated that the treatment with ivy leaf extract is safe in children with acute inflammatory airway disease. The quality of sputum and frequency of cough changed during the treatment, and the majority of physicians and patients estimated that the treatment was more effective than in previous episodes of the disease when they had not received this drug.
{"title":"Treatment of acute respiratory infections in Slovenian children with ivy leaf extract syrup.","authors":"A. Beden, J. Perko, Robert Terčelj, S. Kreft","doi":"10.6016/82","DOIUrl":"https://doi.org/10.6016/82","url":null,"abstract":"Background: The ivy leaf extract is a natural substance with secretolytic effect. Its efficacy and safety have been documented in several randomized, double-blind placebo-controlled trials. The aim of our study was to confirm the safety of ivy leaf extract in Slovenian children with acute inflammatory airway disease and to investigate the course of treatment.\u0000Methods: 193 children with clinical signs of acute airway disease, aged 2 to 14 years were included in a prospective postmarketing study. At the beginning of the study, 7-day treatment with syrup of ivy leaf extract was started.\u0000Results: The treatment was effective in 93.7 % of children, who showed an improvement of clinical symptoms. The proportion of children with productive cough was 43.6 % at first visit and 84.9 % at second visit. Skin allergy as a side effect was reported in one child.\u0000Conclusions: The study demonstrated that the treatment with ivy leaf extract is safe in children with acute inflammatory airway disease. The quality of sputum and frequency of cough changed during the treatment, and the majority of physicians and patients estimated that the treatment was more effective than in previous episodes of the disease when they had not received this drug.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"28 1","pages":"276-284"},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82327934","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}
A. Rozman, M. M. Malovrh, K. Osolnik, Luka Camlek, N. Triller
Abstract: Bronchoscopy with convex probe ultrasound in combination with transbronchial fine-needle aspiration biopsy is a relatively new, minimally invasive method that can also be used in an outpatient setting. It is indicated for staging of the mediastinal and hilar lymph nodes in patients with lung cancer, for the diagnosis of lung and mediastinal tumors, for the diagnosis of mediastinal lymphadenopaty and for the diagnosis and aspiration of mediastinal cysts. The method has a high diagnostic accuracy, which makes it comparable to more invasive diagnostic methods. At the same time it is less invasive for patients and offers a better safety profile.
{"title":"Endobronchial ultrasound for the diagnosis and treatment of mediastinal lesions","authors":"A. Rozman, M. M. Malovrh, K. Osolnik, Luka Camlek, N. Triller","doi":"10.6016/51","DOIUrl":"https://doi.org/10.6016/51","url":null,"abstract":"Abstract: Bronchoscopy with convex probe ultrasound in combination with transbronchial fine-needle aspiration biopsy is a relatively new, minimally invasive method that can also be used in an outpatient setting. It is indicated for staging of the mediastinal and hilar lymph nodes in patients with lung cancer, for the diagnosis of lung and mediastinal tumors, for the diagnosis of mediastinal lymphadenopaty and for the diagnosis and aspiration of mediastinal cysts. The method has a high diagnostic accuracy, which makes it comparable to more invasive diagnostic methods. At the same time it is less invasive for patients and offers a better safety profile.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"3 1","pages":"106-113"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89775922","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}
Katja Kovše, Sonja Tomšič, B. M. Ponikvar, Petra Nadrag
Background: Alcohol consumption is one of the major avoidable risk factors for chronic diseases, injuries and violence. Overall there is a causal relationship between alcohol consumption and more than 60 types of disease and injury. For some of them alcohol is the only possible cause and so they are wholly (100 %) attributable to alcohol.Methods: We have analysed the data on mortality and hospitalisation of Slovenian citizens because of causes wholly attributable to alcohol. We used mortality and hospitalisation data from the National Institute of Public Health’s healthcare databases »Database of Death certificates« and »Data on in-hospital treatments for diseases, injuries and poisoning«. We present the situation in Slovenia in the period from 2007 to 2009 with gender and regional differences analysis. With the mortality data for the period from 2004 to 2008 we also present the impact of socio-economic differences on the mortality wholly attributable to alcohol consumption in Slovenia. For bivariate analysis of the connection between variables we used Chi-square test.Results: In the period from 2007 to 2009 there were on average 811 deaths, of which 509 were premature (4.4 % of all deaths and 12.3 % of all premature deaths), 3799 hospitalisations and 90,589 hospital days (1.3 % of all hospitalisations and 3.8 % of all hospital days in the country in a calendar year) because of causes wholly attributable to alcohol in Slovenia. Men have higher relative risk for death and for hospitalisation because of causes wholly attributable to alcohol than women, and also residents of Eastern Slovenia have higher relative risk than residents of Western Slovenia. Wholly alcohol-attributable mortality is the biggest among residents of the least developed municipalities and is decreasing with the increase of municipality development.Conclusions: Hazardous and harmful alcohol consumption is a big public health problem in Slovenia and it contributes to health inequalities, so activities to reduce its consequences should be increased.
{"title":"Alcohol related harm in Slovenia","authors":"Katja Kovše, Sonja Tomšič, B. M. Ponikvar, Petra Nadrag","doi":"10.6016/718","DOIUrl":"https://doi.org/10.6016/718","url":null,"abstract":"Background: Alcohol consumption is one of the major avoidable risk factors for chronic diseases, injuries and violence. Overall there is a causal relationship between alcohol consumption and more than 60 types of disease and injury. For some of them alcohol is the only possible cause and so they are wholly (100 %) attributable to alcohol.\u0000Methods: We have analysed the data on mortality and hospitalisation of Slovenian citizens because of causes wholly attributable to alcohol. We used mortality and hospitalisation data from the National Institute of Public Health’s healthcare databases »Database of Death certificates« and »Data on in-hospital treatments for diseases, injuries and poisoning«. We present the situation in Slovenia in the period from 2007 to 2009 with gender and regional differences analysis. With the mortality data for the period from 2004 to 2008 we also present the impact of socio-economic differences on the mortality wholly attributable to alcohol consumption in Slovenia. For bivariate analysis of the connection between variables we used Chi-square test.\u0000Results: In the period from 2007 to 2009 there were on average 811 deaths, of which 509 were premature (4.4 % of all deaths and 12.3 % of all premature deaths), 3799 hospitalisations and 90,589 hospital days (1.3 % of all hospitalisations and 3.8 % of all hospital days in the country in a calendar year) because of causes wholly attributable to alcohol in Slovenia. Men have higher relative risk for death and for hospitalisation because of causes wholly attributable to alcohol than women, and also residents of Eastern Slovenia have higher relative risk than residents of Western Slovenia. Wholly alcohol-attributable mortality is the biggest among residents of the least developed municipalities and is decreasing with the increase of municipality development.\u0000Conclusions: Hazardous and harmful alcohol consumption is a big public health problem in Slovenia and it contributes to health inequalities, so activities to reduce its consequences should be increased.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"287 1","pages":"119-127"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81449054","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: Kidney size is an important parameter for evaluating normal kidney development and growth. The purpose of our study was to determine normal range of kidney size according to age, weight and height in our population of children. Patients and methods: 591 children and adolescents referred for abdominal sonography were enrolled. There were 291 boys and 300 girls aged between 0 month and 20 years. Children with known renal disease or abnormal renal ultrasound findings were excluded from the study. The renal length, width and depth were measured on the maximal longitudinal renal diameter and on the transverse diameter at the hilar region, perpendicular to the first measurement. Each kidney was measured twice. Once with the patient in supine and once with the patient in prone position. The renal volume was calculated from the measurements. Results: There were no statistically significant differences in kidney size between boys and girls (p> 0.566). The difference in lenght between left and right kidney was small but statistically significant (p< 0.007). Left kidney was longer and had greater volume than the right one. We presented some tables with normal values of kidney length and volume according to age, body weight and body height for our population of children and young people. Conclusions: We believe that our tables with normal values of kidney length and volume will provide a useful references for kidney evaluation by ultrasonography in children. We suggest correlation with body height for the kidney length and correlation with body weight for the kidney volume evaluation.
{"title":"Sonographic measurements of renal size in slovenian population of children","authors":"Andreja Dvoršak Erker, A. Gregorič","doi":"10.6016/92","DOIUrl":"https://doi.org/10.6016/92","url":null,"abstract":"Background: Kidney size is an important parameter for evaluating normal kidney development and growth. The purpose of our study was to determine normal range of kidney size according to age, weight and height in our population of children. Patients and methods: 591 children and adolescents referred for abdominal sonography were enrolled. There were 291 boys and 300 girls aged between 0 month and 20 years. Children with known renal disease or abnormal renal ultrasound findings were excluded from the study. The renal length, width and depth were measured on the maximal longitudinal renal diameter and on the transverse diameter at the hilar region, perpendicular to the first measurement. Each kidney was measured twice. Once with the patient in supine and once with the patient in prone position. The renal volume was calculated from the measurements. Results: There were no statistically significant differences in kidney size between boys and girls (p> 0.566). The difference in lenght between left and right kidney was small but statistically significant (p< 0.007). Left kidney was longer and had greater volume than the right one. We presented some tables with normal values of kidney length and volume according to age, body weight and body height for our population of children and young people. Conclusions: We believe that our tables with normal values of kidney length and volume will provide a useful references for kidney evaluation by ultrasonography in children. We suggest correlation with body height for the kidney length and correlation with body weight for the kidney volume evaluation.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"54 1","pages":"18-24"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89153444","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}
Sudden cardiac deaths in young athletes (lessthan 35 years old) are rare though highly publicizedtragedies, occurring mainly in athletes withunderlying cardiovascular diseases. Since thesediseases often have a clinically silent course,they should be actively searched for by preparticipationscreening. Preparticipation screeningof athletes varies among different countries.However, a common European protocol hasbeen proposed, which comprises a history, clinicalexamination, and 12-lead electrocardiogram(ECG). The inclusion of ECG is based mainly onItalian results, which showed increased sensitivityof such screening for a majority of cardiovasculardiseases responsible for sudden cardiacdeath (cardiomyopathies, channelopaties, cardiacconduction tissue diseases). Timely diagnosisof such cardiovascular diseases, abstinence fromexercise of moderate to high intensity, pharmacotherapyand other treatment modalities helpto prevent sudden cardiac deaths and progressionof disease in the affected athletes.
{"title":"Prevention of sudden cardiac death in young athletes","authors":"K. A. Juvan, P. Zupet","doi":"10.6016/348","DOIUrl":"https://doi.org/10.6016/348","url":null,"abstract":"Sudden cardiac deaths in young athletes (less\u0000than 35 years old) are rare though highly publicized\u0000tragedies, occurring mainly in athletes with\u0000underlying cardiovascular diseases. Since these\u0000diseases often have a clinically silent course,\u0000they should be actively searched for by preparticipation\u0000screening. Preparticipation screening\u0000of athletes varies among different countries.\u0000However, a common European protocol has\u0000been proposed, which comprises a history, clinical\u0000examination, and 12-lead electrocardiogram\u0000(ECG). The inclusion of ECG is based mainly on\u0000Italian results, which showed increased sensitivity\u0000of such screening for a majority of cardiovascular\u0000diseases responsible for sudden cardiac\u0000death (cardiomyopathies, channelopaties, cardiac\u0000conduction tissue diseases). Timely diagnosis\u0000of such cardiovascular diseases, abstinence from\u0000exercise of moderate to high intensity, pharmacotherapy\u0000and other treatment modalities help\u0000to prevent sudden cardiac deaths and progression\u0000of disease in the affected athletes.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"35 2 1","pages":"774-781"},"PeriodicalIF":0.0,"publicationDate":"2010-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79719596","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}
A. Marin, Igor Požek, R. Erzen, P. M. Brguljan, M. Košnik
Purpose of the Study: Clinical prediction modelshave been developed to assess the pre-testprobability for pulmonary embolism (PE). TheWells model and the revised Geneva score arethe two most well studied. Our purpose was tocompare the two prediction models, and indentifythe frequent clinical findings of PE in patientsadmitted to the University Clinic of Pulmonaryand Allergic Diseases Golnik.Methods: In 100 random emergency departmentpatients and hospital inpatients withsuspected PE and performed pulmonary CTangiography (CTPA) as the gold standard, a retrospectiveassessment of the clinical probabilityof PE by the Wells rule and the revised Genevascore was made. ECG, D-dimer, NT-proBNP, arterialblood gas analysis, chest X-ray, CTPA and13 other clinical findings were analysed as well.Results: Average age was 65 years (SD 14.5), 39 %were male. The overall prevalence of PE was33 %. The rates of PE in low, moderate, and highPE risk groups as determined according to theWells model and the revised Geneva score were3.7, 53,1, 100, and 14.3, 32.1, 83.3 %, respectively.ROC analysis showed that the Wells model wasstatistically more accurate than the Geneva scorewith the area under the curve (AUC) in Wellsmodel 0.85 (95 % CI 0.762–0.936) and in Genevascore 0.73 (95 % CI 0.612–0.838). Suddendyspnea, active malignancy, venous thromboembolism(VTE) history, estrogen therapy, deepvein thrombosis (DVT) signs, ECG changes andlower PaCO2 were significantly more frequent inPE group. All patients with PE had an increasedconcentration of D-dimer, and no PE were diagnosedin the group of patients with normalD-dimer. CTPA was ordered in 17 % of patientswith low pre-test probability of PE according toWells criteria and normal D-dimer. Conclusions: The Wells model is more accuratethan the Geneva scoring system for the diagnosisof PE in patients admitted to a pulmonaryclinic. Additional findings, such as sudden dyspnea,estrogen therapy, ECG changes and lowerPaCO2, should always be incorporated in clinicalassessment of PE. Adding the Wells algorithm tothe clinical pathway for PE management mightslightly decrease the number of CTPA.
研究目的:已经建立了临床预测模型来评估肺栓塞(PE)的检测前概率。威尔斯模型和修订后的日内瓦分数是研究得最多的两个模型。我们的目的是比较两种预测模型,并确定在大学肺部和过敏性疾病诊所就诊的患者中PE的常见临床表现。方法:随机选取100例疑似PE的急诊科患者和医院住院患者,以行肺造影(CTPA)为金标准,采用Wells规则和修订Genevascore对PE的临床概率进行回顾性评价。并分析了心电图、d -二聚体、NT-proBNP、动脉血气分析、胸片、CTPA等13项临床表现。结果:平均年龄65岁(SD 14.5),男性占39%。PE的总患病率为33%。根据wells模型和修订后的Geneva评分,低、中、高PE风险组的PE发生率分别为3.7、53、1100和14.3%、32.1%和83.3%。ROC分析显示,Wells模型的曲线下面积(AUC)为0.85 (95% CI 0.762-0.936), Genevascore的AUC为0.73 (95% CI 0.612-0.838),在统计学上优于Geneva评分。pe组患者突发性呼吸困难、活动性恶性肿瘤、静脉血栓栓塞(VTE)史、雌激素治疗、深静脉血栓形成(DVT)征象、心电图改变及PaCO2降低的发生率显著高于pe组。所有PE患者的d -二聚体浓度均升高,正常组未诊断为PE。根据toWells标准和正常d -二聚体,17%的PE检测前概率较低的患者接受CTPA治疗。结论:在肺科门诊就诊的患者中,Wells模型比Geneva评分系统诊断PE更准确。其他发现,如突发性呼吸困难、雌激素治疗、心电图改变和paco2降低,应始终纳入PE的临床评估。将Wells算法添加到PE管理的临床路径中可能会略微减少CTPA的数量。
{"title":"Improving diagnostics of pulmonary embolism with clinical prediction models in a clinic of pulmonary diseases","authors":"A. Marin, Igor Požek, R. Erzen, P. M. Brguljan, M. Košnik","doi":"10.6016/338","DOIUrl":"https://doi.org/10.6016/338","url":null,"abstract":"Purpose of the Study: Clinical prediction models\u0000have been developed to assess the pre-test\u0000probability for pulmonary embolism (PE). The\u0000Wells model and the revised Geneva score are\u0000the two most well studied. Our purpose was to\u0000compare the two prediction models, and indentify\u0000the frequent clinical findings of PE in patients\u0000admitted to the University Clinic of Pulmonary\u0000and Allergic Diseases Golnik.\u0000Methods: In 100 random emergency department\u0000patients and hospital inpatients with\u0000suspected PE and performed pulmonary CT\u0000angiography (CTPA) as the gold standard, a retrospective\u0000assessment of the clinical probability\u0000of PE by the Wells rule and the revised Geneva\u0000score was made. ECG, D-dimer, NT-proBNP, arterial\u0000blood gas analysis, chest X-ray, CTPA and\u000013 other clinical findings were analysed as well.\u0000Results: Average age was 65 years (SD 14.5), 39 %\u0000were male. The overall prevalence of PE was\u000033 %. The rates of PE in low, moderate, and high\u0000PE risk groups as determined according to the\u0000Wells model and the revised Geneva score were\u00003.7, 53,1, 100, and 14.3, 32.1, 83.3 %, respectively.\u0000ROC analysis showed that the Wells model was\u0000statistically more accurate than the Geneva score\u0000with the area under the curve (AUC) in Wells\u0000model 0.85 (95 % CI 0.762–0.936) and in Geneva\u0000score 0.73 (95 % CI 0.612–0.838). Sudden\u0000dyspnea, active malignancy, venous thromboembolism\u0000(VTE) history, estrogen therapy, deep\u0000vein thrombosis (DVT) signs, ECG changes and\u0000lower PaCO2 were significantly more frequent in\u0000PE group. All patients with PE had an increased\u0000concentration of D-dimer, and no PE were diagnosed\u0000in the group of patients with normal\u0000D-dimer. CTPA was ordered in 17 % of patients\u0000with low pre-test probability of PE according to\u0000Wells criteria and normal D-dimer. Conclusions: The Wells model is more accurate\u0000than the Geneva scoring system for the diagnosis\u0000of PE in patients admitted to a pulmonary\u0000clinic. Additional findings, such as sudden dyspnea,\u0000estrogen therapy, ECG changes and lower\u0000PaCO2, should always be incorporated in clinical\u0000assessment of PE. Adding the Wells algorithm to\u0000the clinical pathway for PE management might\u0000slightly decrease the number of CTPA.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"46 1","pages":"698-706"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89641270","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}
Ž. Novak, V. Cerar, Z. R. Primec, V. Dolžan, L. Steblovnik, M. Hawlina
Regarding medical science and profession everybodystrives to be updated. We as physicianshave never, however, been trained how to traintrainees, even though adult education is a continuouslydeveloping science as well. This scienceoffers to trainers more efficient tools to teach, appraiseand assess trainees in a rather short timeavailable. We owe it to ourselves and medicine totrain new specialists in such a way that they willbe competent in their specialities. As trainers wecan positively contribute to higher self-reflectionand responsibility of trainees with introductoryappraisal–it is so nice when mentor knows theCV of the trainee in advance–and with repeatingthe appraisal in regular intervals. The importanceof solid basic knowledge and continuousassessment of theoretical knowledge, practicalskills and, above all, of attitude and behaviouris stressed. The first audit cycle of Training thetrainers workshops will not be completed untilafter some years. But what is already evident isthe fact that trainers are offered positive, usefuland enjoyable tools.
{"title":"Why should one join a TT program? Ask a colleague! - or experience after a dozen of TT workshops","authors":"Ž. Novak, V. Cerar, Z. R. Primec, V. Dolžan, L. Steblovnik, M. Hawlina","doi":"10.6016/343","DOIUrl":"https://doi.org/10.6016/343","url":null,"abstract":"Regarding medical science and profession everybody\u0000strives to be updated. We as physicians\u0000have never, however, been trained how to train\u0000trainees, even though adult education is a continuously\u0000developing science as well. This science\u0000offers to trainers more efficient tools to teach, appraise\u0000and assess trainees in a rather short time\u0000available. We owe it to ourselves and medicine to\u0000train new specialists in such a way that they will\u0000be competent in their specialities. As trainers we\u0000can positively contribute to higher self-reflection\u0000and responsibility of trainees with introductory\u0000appraisal–it is so nice when mentor knows the\u0000CV of the trainee in advance–and with repeating\u0000the appraisal in regular intervals. The importance\u0000of solid basic knowledge and continuous\u0000assessment of theoretical knowledge, practical\u0000skills and, above all, of attitude and behaviour\u0000is stressed. The first audit cycle of Training the\u0000trainers workshops will not be completed until\u0000after some years. But what is already evident is\u0000the fact that trainers are offered positive, useful\u0000and enjoyable tools.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"35 1","pages":"742-747"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81968069","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}
M. Bunc, K. A. Juvan, J. Ambrožič, Š. Mušič, Bojan Kontestabile, A. Cerar, Irena Lopatič, N. Lakič, D. Zorman
Calcified aortic stenosis is the most frequentvalvular heart disease in the Western world. Itis a progressive, degenerative, atheroscleroticlikeprocess that involves the aortic valve withincreasing prevalence as the population ages.Surgical aortic valve replacement is the treatmentof choice for patients with severe, symptomaticaortic stenosis, but it has limitations inold patients with high perioperative risk and inpatients with comorbidities. A new method ofpercutanous aortic valve implantation has beendeveloped recently. It is indicated in symptomaticpatients with high perioperative risk.Case report: A case of a 83-year-old female patientwith severe, symptomatic aortic valve stenosisand a high haemorrhagic risk due to vascular–ectatic changes after surgery for gastriccarcinoid tumor is reported. She was refused forsurgical aortic valve replacement. Transfemoralimplantation of Edwards SAPIEN aortic valvewas indicated. On the day after implantation the patient stood up; she improved clinically as wellas objectively.Conclusions: Our case shows that there are additionaltherapeutic options for high-risk patientswith severe aortic stenosis. Transfemoralaortic valve implantation is a procedure thatdoes not require anaesthesia and thoracotomy. The implantation requires teamwork involvinginterventional cardiologist, cardio-vascularsurgeon and anaesthesiologist. The real clinicalvalue of the method is yet to be established asa result of ongoing clinical trials and in cooperationbetween interventional cardiologists andcardiac surgeons.
{"title":"First transfemoral biologic aortic valve implantation in Slovenia","authors":"M. Bunc, K. A. Juvan, J. Ambrožič, Š. Mušič, Bojan Kontestabile, A. Cerar, Irena Lopatič, N. Lakič, D. Zorman","doi":"10.6016/342","DOIUrl":"https://doi.org/10.6016/342","url":null,"abstract":"Calcified aortic stenosis is the most frequent\u0000valvular heart disease in the Western world. It\u0000is a progressive, degenerative, atheroscleroticlike\u0000process that involves the aortic valve with\u0000increasing prevalence as the population ages.\u0000Surgical aortic valve replacement is the treatment\u0000of choice for patients with severe, symptomatic\u0000aortic stenosis, but it has limitations in\u0000old patients with high perioperative risk and in\u0000patients with comorbidities. A new method of\u0000percutanous aortic valve implantation has been\u0000developed recently. It is indicated in symptomatic\u0000patients with high perioperative risk.\u0000Case report: A case of a 83-year-old female patient\u0000with severe, symptomatic aortic valve stenosis\u0000and a high haemorrhagic risk due to vascular–\u0000ectatic changes after surgery for gastric\u0000carcinoid tumor is reported. She was refused for\u0000surgical aortic valve replacement. Transfemoral\u0000implantation of Edwards SAPIEN aortic valve\u0000was indicated. On the day after implantation the patient stood up; she improved clinically as well\u0000as objectively.\u0000Conclusions: Our case shows that there are additional\u0000therapeutic options for high-risk patients\u0000with severe aortic stenosis. Transfemoral\u0000aortic valve implantation is a procedure that\u0000does not require anaesthesia and thoracotomy. The implantation requires teamwork involving\u0000interventional cardiologist, cardio-vascular\u0000surgeon and anaesthesiologist. The real clinical\u0000value of the method is yet to be established as\u0000a result of ongoing clinical trials and in cooperation\u0000between interventional cardiologists and\u0000cardiac surgeons.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"16 1","pages":"735-741"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79113744","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}
The term dual diagnosis is used to describe thecomorbid condition of substance use disorderand other mental disorder. The prevalence ofsubstance use disorders is higher among patientswith other mental disorders than in general population.Regarding prognosis in the treatment ofpatients with comorbid disorders, both disordershave a poorer outcome when undertreated.There are four models explaining aetiology ofdual diagnosis: common factor models, secondarysubstance use disorder models, secondarypsychiatric disorder models and bidirectionalmodels.Differentiation between primary psychotic disordersthat co-occur with substance use and substanceinduced psychosis is generally difficult,but it is important for understanding the courseof illness and effective treatment planning. Threetreatment approaches are used in patients withcomorbid substance use disorder and anothermental disorder: parallel, sequentional and integrative–the last one supposed to be more effectivethan others. Therapeutic approaches in thetreatment of patients with dual diagnosis includepsychoeducation, motivational interventions,cognitive–behavioural therapy, social skillstraining and psycho-pharmacotherapy.
{"title":"Treatment of patients with comorbidity of substance use disorder and psychotic disorder.","authors":"N. Šegrec, A. Kastelic","doi":"10.6016/320","DOIUrl":"https://doi.org/10.6016/320","url":null,"abstract":"The term dual diagnosis is used to describe the\u0000comorbid condition of substance use disorder\u0000and other mental disorder. The prevalence of\u0000substance use disorders is higher among patients\u0000with other mental disorders than in general population.\u0000Regarding prognosis in the treatment of\u0000patients with comorbid disorders, both disorders\u0000have a poorer outcome when undertreated.\u0000There are four models explaining aetiology of\u0000dual diagnosis: common factor models, secondary\u0000substance use disorder models, secondary\u0000psychiatric disorder models and bidirectional\u0000models.\u0000Differentiation between primary psychotic disorders\u0000that co-occur with substance use and substance\u0000induced psychosis is generally difficult,\u0000but it is important for understanding the course\u0000of illness and effective treatment planning. Three\u0000treatment approaches are used in patients with\u0000comorbid substance use disorder and another\u0000mental disorder: parallel, sequentional and integrative–\u0000the last one supposed to be more effective\u0000than others. Therapeutic approaches in the\u0000treatment of patients with dual diagnosis include\u0000psychoeducation, motivational interventions,\u0000cognitive–behavioural therapy, social skills\u0000training and psycho-pharmacotherapy.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"14 1","pages":"566-574"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75608038","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}