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61.
Selpercatinib in RET fusion-positive non-small-cell lung cancer (SIREN) : a retrospective analysis of patients treated through an access program
Oliver Illini, Maximilian J Hochmair, Hannah Fabikan, Christoph Weinlinger, Amanda Tufman, Aurélie Swalduz, Kristina Lamberg, Sayed M. S. Hashemi, Florian Huemer, Anders Vikström, Katja Mohorčič, 2021

Povzetek: Introduction: Rearranged during transfection (RET) gene fusions are rare genetic drivers in non-small cell lung cancer (NSCLC). Selective RET-inhibitors such as selpercatinib have shown therapeutic activity in early clinical trials; however, their efficacy in the real-world setting is unknown. Methods: A retrospective efficacy and safety analysis was performed on data from RET fusio-%positive NSCLC patients who participated in a selpercatinib access program (named patient protocol) between August 2019 and January 2021. Results: Data from 50 patients with RET fusion-positive advanced NSCLC treated with selpercatinib at 27 centers in 12 countries was analyzed. Most patients were Non-Asian (90%), female (60%), never-smokers (74%), with a median age of 65 years (range, 38-89). 32% of the patients had known brain metastasis at the time of selpercatinib treatment. Overall, 13 patients were treatment-naïve, while 37 were pretreated with a median of three lines of therapy (range, 1-8). The objective response rate (ORR) was 68% [95% confidence interval (CI), 53-81] in the overall population. The disease control rate was 92%. The median progression-free survival was 15.6 months (95% CI, 8.8-22.4) after a median follow-up of 9 months. In patients with measurable brain metastases (n=8) intracranial ORR reached 100%. In total, 88% of patients experienced treatment-related adverse events (TRAEs), a large majority of them being grade 1 or 2. The most common grade >/=3 TRAEs were increased liver enzyme levels (in 10% of patients), prolonged QTc time (4%), abdominal pain (4%), hypertension (4%), and fatigue/asthenia (4%). None of patients discontinued selpercatinib treatment for safety reasons. No new safety concerns were observed, nor where there any treatment-related death. Conclusions: In this real-world setting, the selective RET-inhibitor selpercatinib demonstrated durable systemic and intracranial antitumor activity in RET fusion-positive NSCLC and was well tolerated.
Ključne besede: non-small cell lung carcinoma -- drug therapy -- genetics, molecular targeted therapy, real-world data, selpercatinib, targeted therapy, tyrosine kinase inhibitor
DiRROS - Objavljeno: 16.06.2021; Ogledov: 307; Prenosov: 122
.pdf Celotno besedilo (777,25 KB)

62.
Neuromuscular junction instability and altered intracellular calcium handling as early determinants of force loss during unloading in humans
Elena Monti, Carlo Reggiani, Martino V. Franchi, Luana Toniolo, Marco Sandri, Andrea Armani, Sandra Zampieri, Boštjan Šimunič, Rado Pišot, Marco Vincenzo Narici, 2021

Povzetek: Unloading induces rapid skeletal muscle atrophy and functional decline. Importantly, force is lost at a much higher rate than muscle mass. We aimed to investigate the early determinants of the disproportionate loss of force compared to that of muscle mass in response to unloading. Ten young participants underwent 10 days of bed rest (BR). At baseline (BR0) and at 10 days (BR10), quadriceps femoris (QF) volume (VOL) and isometric maximum voluntary contraction (MVC) were assessed. At BR0 and BR10 blood samples and biopsies of vastus lateralis (VL) muscle were collected. Neuromuscular junction (NMJ) stability and myofibre innervation status were assessed, together with single fibre mechanical properties and sarcoplasmic reticulum (SR) calcium handling. From BR0 to BR10, QFVOL and MVC decreased by 5.2% (P = 0.003) and 14.3% (P < 0.001), respectively. Initial and partial denervation was detected from increased neural cell adhesion molecule (NCAM)-positive myofibres at BR10 compared with BR0 (+3.4%, P = 0.016). NMJ instability was further inferred from increased C-terminal agrin fragment concentration in serum (+19.2% at BR10, P = 0.031). Fast fibre cross-sectional area (CSA) showed a trend to decrease by 15% (P = 0.055) at BR10, while single fibre maximal tension (force/CSA) was unchanged. However, at BR10 SR Ca2+ release in response to caffeine decreased by 35.1% (P < 0.002) and 30.2% (P < 0.001) in fast and slow fibres, respectively, pointing to an impaired excitation%contraction coupling. These findings support the view that the early onset of NMJ instability and impairment in SR function are eligible mechanisms contributing to the greater decline in muscle force than in muscle size during unloading.
Ključne besede: Ca2+ dynamics, muscle atrophy, neuromuscular junction instability, sarcoplasmic reticulum, single fibre atrophy, single fibre contractile impairment, unloading
DiRROS - Objavljeno: 16.06.2021; Ogledov: 193; Prenosov: 206
.pdf Celotno besedilo (3,39 MB)

63.
Green space area and type affect bird communities in a South-eastern European city
Maarten De Groot, Katarina Flajšman, Tomaž Mihelič, Urša Vilhar, Primož Simončič, Andrej Verlič, 2021

Povzetek: Urbanization decreases the species richness and results in the homogenization of bird communities. Bird species are important indicator species for biodiversity and reflect the habitat quality of urban forests and other green spaces. In this study we investigated the key drivers that influence bird communities in urban forests and green spaces in the Southeastern European city of Ljubljana, Slovenia. We were interested in how the number of species, species dissimilarity and indicator species are affected by the type of green space (urban forest vs park), area of green space and type of urbanization (urban vs peri-urban areas). We sampled birds twice in 2012 in 39 standardized point counts across Ljubljana. We found that the abundance was influenced by the area of the green space. Species dissimilarity and species turnover are affected by the area and type of green space. Interestingly, the analysis showed that the species composition of peri-urban areas was similar to that of urban areas. Indicator species were found for all environmental variables. On the basis of the results, we suggest the strategy that would increase the diversity of birds and increase the stability of their populations in urban areas. Urban planners should encourage 1) both forests and parks since they harbour different species of birds, 2) larger green spaces since larger areas have species that are more typical of larger areas and 3) a mosaic of a larger number of smaller forest remnants combined with larger forest complex serving as source areas.
Ključne besede: urban forest, bird species composition, forest remnant, urbanization, peri-urban forest, bird monitoring, species richness
DiRROS - Objavljeno: 14.06.2021; Ogledov: 182; Prenosov: 134
URL Celotno besedilo (0,00 KB)
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64.
Zdravljenje intrahepatalnega holangiokarcinoma s stereotaktičnim obsevanjem : prikaz primera
Anja Meden, Ajra Šečerov Ermenc, 2021

Povzetek: V prispevku je opisan primer bolnice z lokalno napredovalim holangiokarcinomom intrahepatalnih žolčnih vodov, ki je redek malignom s svojevrstnim kliničnim potekom. Ob postavitvi diagnoze ima večina bolnikov napredovalo obliko bolezni in so posledično kandidati le za nekirurško zdravljenje – kemoterapijo, kombinacijo kemoterapije in radioterapije ali samo radioterapijo. Glavna omejitev pri zdravljenju z radioterapijo je doza, ki jo prejmejo jetra in priležni cevasti organi, zato se v zadnjem času čedalje bolj uveljavlja zdravljenje s stereotaktično radioterapijo. Ta omogoča, da dovedemo visoko dozo na tumor, pri čemer ščitimo rizične organe. Raziskave, ki so bile objavljene v zadnjih letih, so pokazale dobre rezultate zdravljenja inoperabilne bolezni z namenom poskusa zazdravitve bolezni in podaljšanja celokupnega preživetja.
Ključne besede: intrahepatalni holangiokarcinom, stereotaktično obsevanje, radioterapija
DiRROS - Objavljeno: 11.06.2021; Ogledov: 161; Prenosov: 59
.pdf Celotno besedilo (554,08 KB)

65.
Vpliv visokodozne in nizkodozne izpostavljenosti srčnih struktur na srčno-žilne posledice obsevanja raka dojke in raka pljuč
Ivica Ratoša, Jasna But Hadžić, 2021

Povzetek: Izhodišča: Z daljšanjem preživetja bolnikov z rakom so srčno- -žilne bolezni postale pomemben del morbiditete in mortalitete teh bolnikov. V zadnjih letih je v literaturi veliko zanimanja na področju vpliva radioterapije na pozne posledice na srcu. Metode: Literaturo smo poiskali s pomočjo spletnega iskalnika PubMed / MEDLINE z uporabo kombinacij ustreznih ključnih besed. V postopku ocenjevanja smo preučili grobe rezultate iskanja in izključili članke, ki niso pomembni za to temo. Upoštevali smo le literaturo v angleškem jeziku. Rezultati: Objavljene so različne doznovolumske omejitve na srce v povezavi s srčno-žilnimi obolenji in smrtnostjo, vendar te omejitve niso enotno veljavne. Pri dopolnilnem obsevanju raka dojk je celotno srce izpostavljeno nizki dozi in se pomembne srčne okvare najpogosteje izrazijo desetletje po zdravljenju ali še pozneje, pri visokodozni izpostavljenosti pri radikalnem obsevanju pljuč pa se smrtnost zaradi srčno-žilnih dogodkov poveča že v prvih letih po zdravljenju. Zaključek: Z nižanjem doze na srce lahko še dodatno vplivamo na preživetje bolnikov po obsevanju, kar nam že omogočajo boljše obsevalne tehnike in slikovno vodena radioterapija. Dodatno korist lahko dosežemo še z boljšim razumevanjem in upoštevanjem vpliva obsevanja na posamezne srčne strukture, tudi v povezavi z pridruženimi boleznimi, in z usmerjenim kardiološkim spremljanjem bolnikov po obsevanju prsnega koša.
Ključne besede: obsevanje, rak dojk, rak pljuč
DiRROS - Objavljeno: 11.06.2021; Ogledov: 159; Prenosov: 65
.pdf Celotno besedilo (794,57 KB)

66.
Vpliv epidemije covida-19 na izvajanje akutne paliativne oskrbe v onkologiji
Marjana Bernot, Maja Ebert Moltara, Branko Zakotnik, 2021

Povzetek: Izhodišče: Spomladi 2020 je izbruhnila pandemija covida-19 in močno vplivala na globalno družbo, posebno na zdravstveni sistem. Epidemiološke razmere in posledični ukrepi so vplivali na obravnavo bolnikov, ki so vključeni v specializirano paliativno obravnavo. Metode: V raziskavi so bili zbrani podatki o številu in vrsti obravnav bolnikov z rakom, vključenih v akutno paliativno oskrbo na Onkološkem inštitutu Ljubljana (OI), in podana opažanja v povezavi s covidom-19 v primerjavi s podatki pred izbruhom epidemije. Rezultati: Leta 2020 smo beležili 25 % več napotitev kot leta 2019. Povprečna ležalna doba se je zmanjšala s 6,2 na 5,1 dneva. Povprečno število družinskih sestankov v obdobju pred covidom19 je bilo 148, lani 214. Koledarsko leto covida-19 in število odpustov oziroma smrti sta statistično značilno povezana med seboj. Leta 2020 je na Oddelku za akutno paliativno oskrbo (OAPO) umrlo več oseb, kot bi bilo pričakovano (p < 0,05, z vrednostjo = 2,76), statistično značilno manj oseb, je bilo premeščenih v hospic (p < 0,05, z vrednostjo = %2,01) in drugam (p < 0,05, z vrednostjo = %2,56). ). V letu 2020 je bilo izvedenih 22 % več ambulantnih pregledov od povprečja preteklih let. Pandemija je vplivala na izvajanje obravnav specializirane paliativne oskrbe. Zaključek: Oskrba za bolnike z rakom in paliativno oskrbo je bila v času covida-19 omejena. Pred nas je postavila pomembne izzive v zagotavljanju paliativne oskrbe. Krizni model organizacije paliativne oskrbe je bil bolj ali manj usmerjen v oskrbo umirajočih. O zagotavljanju celostne integrirane paliativne oskrbe pri obravnavi bolnikov z rakom v tem obdobju ne moremo govoriti. A vendar je paliativna oskrba postala bolj prepoznavana na globalni ravni.
Ključne besede: covid-19, paliativna oskrba, onkologija
DiRROS - Objavljeno: 11.06.2021; Ogledov: 141; Prenosov: 59
.pdf Celotno besedilo (270,81 KB)

67.
Independent infuence of age on heart rate recovery after flywheel exercise in trained men and women
Damir Zubac, Nandu Goswami, Vladimir Ivančev, Zoran Valić, Boštjan Šimunič, 2021

Povzetek: The present study examined whether differences in the heart rate recovery following flywheel exercise cessation were associated with differences in maximal oxygen uptake (V%O2 max.), age and sex in trained adults. Eleven men (age range 22%49 years, V%O2 max.%=%43.6%%%7.6 mL kg min%1) and ten women (age range 20%53 years, V%O2 max.%=%38.0%%%5.7 mL kg min%1) were randomly assigned to complete a squat-exercise on the flywheel ergometer set at three different moments of inertia, while their cardiovascular responses were continuously monitored. During the flywheel exercise the mean arterial pressure rose by%~%35 to 40% (p%=%.001), and the increment was more robust in men than women. The cardiac index was two-fold greater across both sexes compared to the baseline (p%=%.001), while the rise in heart rate (~%144 bpm) was more pronounced in women to compensate for their load-dependent stroke index decline (p%=%.001). The load-independent time-course changes in heart rate recovery markers were comparable between the sexes. When these indicators were pooled, a stepwise regression revealed age as the only relevant predictor of both fast and slow components of the heart rate recovery (~%30% of the shared variance explained, p%=%.014). The present data suggest that the heart rate recovery declines with age, irrespective of sex, or well-preserved cardiorespiratory fitness in moderately-trained adults.
Ključne besede: training, exercise, Yo-Yo exercise, flywheel, heart rate variability, total peripheral conductance, oxygen uptake kinetics
DiRROS - Objavljeno: 11.06.2021; Ogledov: 194; Prenosov: 126
.pdf Celotno besedilo (1,64 MB)

68.
Effect of a warm-up protocol with and without facemask-use against COVID-19 on cognitive function : ǂa ǂpilot, randomized counterbalanced, cross-sectional study
Maamer Slimani, Bianca Miarka, Hela Znazen, Wassim Moalla, Amri Hammami, Armin Paravlić, Nicola Luigi Bragazzi, 2021

Povzetek: The present study aimed to verify the effect of a warm-up protocol with and without facemask-use on cognitive function. The sample was composed of 17 healthy, non-smoking physical education students (age = 17.6 years, height = 1.71 m, and body mass = 69.7 kg). They were randomized to perform 15 min of warm-up exercises, while wearing a cloth facemask (EXP) or no mask (CON) on two separate occasions, with at least 48-h separating conditions. Rate of perceived exertion (RPE) and d2 Attention assessment were used to verify cognitive function, using a repeated measures general linear model. The warm-up improved cognitive abilities and the results demonstrated significant differences between the EXP vs. CON groups in post-concentration performance (186.06 % 15.47 EXP-score vs. 178.12 % 13.66 CON-score), post the total number of errors (23.47 % 14.50 EXP-frequency < 29.06 % 13.74 CON-frequency), and in the post RPE (6.0 % 1.37 EXP-index > 4.7 % 0.85 CON-index). Wearing a cloth facemask caused positive effects on cognitive function. This data suggests that wearing a cloth facemask during warm-up may stimulate/improve the cognitive function.
Ključne besede: pandemic, coronavirus, COVID-19, physical activities, exercises, facemasks, warm-up protocol, cognitive functions, neuropsychological tests
DiRROS - Objavljeno: 11.06.2021; Ogledov: 211; Prenosov: 130
.pdf Celotno besedilo (320,39 KB)

69.
70.
Priporočila za obravnavo bolnikov z rakom glave in vratu v Sloveniji
Primož Strojan, Aleksandar Aničin, Jelena Azarija, Saba Battelino, Bogdan Čizmarevič, Vojislav Didanovič, Tadej Dovšak, Marta Dremelj, Aleš Fidler, Matic Glavan, Cvetka Grašič-Kuhar, Aleš Grošelj, Andrej Kansky, Katarina Barbara Karner, Marko Kokalj, Matic Koren, Jana Krapež, Hojka Kuralt, Boštjan Lanišnik, Primož Levart, Jure Orel, Jošt Pavčič, Gaber Plavc, Luka Prodnik, Peter Pukl, Robert Šifrer, Matija Švagan, Jure Urbančič, Branko Zakotnik, Nina Zidar, Barbara Žumer, 2021

Povzetek: Priporočila za obravnavo rakov glave in vratu (RGV) v Sloveniji sledijo priporočilom in usmeritvam, povzetim v publikaciji neprofitne mreže 30 vodilnih severnoameriških inštitucij za obravnavo raka, National Comprehensive Cancer Network,1 in hkrati upoštevajo obstoječe zmožnosti slovenskega zdravstvenega sistema. Smernice predstavljajo poenoteno mnenje vseh štirih najpomembnejših deležnikov na področju obravnave rakov glave in vratu v državi: Klinike za otorinolaringologijo in cervikofacialno kirurgijo, Kliničnega oddelka za maksilofacialno in oralno kirurgijo ter Stomatološke klinike UKC Ljubljana, Klinike za otorinolaringologijo, cervikalno in maksilofacialno kirurgijo UKC Maribor ter Onkološkega inštituta Ljubljana
Ključne besede: rak glave in vratu, zdravljenje, onkolško zdravljenje
DiRROS - Objavljeno: 11.06.2021; Ogledov: 187; Prenosov: 62
.pdf Celotno besedilo (258,88 KB)

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