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Adrenal vein sampling for primary aldosteronism : a 15-year national referral center experience
Tomaž Kocjan, Mojca Jensterle Sever, Gaj Vidmar, Rok Vrčkovnik, Pavel Berden, Milenko Stankovič, 2020, original scientific article

Abstract: Background Adrenal vein sampling (AVS) is essential for diagnostics of primary aldosteronism, distinguishing unilateral from bilateral disease and determining treatment options. We reviewed the performance of AVS for primary aldosteronism at our center during first 15 years, comparing the initial period to the period after the introduction of a dedicated radiologist. Additionally, AVS outcomes were checked against CT findings and the proportion of operated patients with proven unilateral disease was estimated. Patients and methods A retrospective cross-sectional study conducted at the national endocrine referral center included all patients with primary aldosteronism who underwent AVS after its introduction in 2004 until the end of 2018. AVS was performed sequentially during Synacthen infusion. When the ratio of cortisol concentrations from adrenal vein and inferior vena cava was at least 5, AVS was considered successful. Results Data from 235 patients were examined (168 men; age 32%73, median 56 years; BMI 18%48, median 30.4 kg/ m2). Average number of annual AVS procedures increased from 7 in the 2004%2011 period to 29 in the 2012%2018 period (p < 0.001). AVS had to be repeated in 10% of procedures; it was successful in 77% of procedures and 86% of patients. The proportion of patients with successful AVS (92% in 2012%2018 vs. 66% in 2004%2011, p < 0.001) and of successful AVS procedures (82% vs. 61%, p < 0.001) was statistically significantly higher in the recent period. Conclusions Number of AVS procedures and success rate at our center increased over time. Introduction of a dedicated radiologist and technical advance expanded and improved the AVS practice.
Keywords: angiography, adrenal gland, endocrine disorders
Published in DiRROS: 15.07.2024; Views: 46; Downloads: 25
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Dynamics of CT visible pleural effusion in patients with pulmonary infarction
Igor Kocijančič, Jernej Vidmar, Marko Kastelic, 2018, original scientific article

Keywords: pulmonary infarction, pleural effusion, pulmonary embolism, CTA of pulmonary arteries
Published in DiRROS: 11.06.2024; Views: 109; Downloads: 61
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Glioblastoma in patients over 70 years of age
Uroš Smrdel, Marija Skoblar Vidmar, Aleš Smrdel, 2018, original scientific article

Keywords: glioblastoma, elderly, patients, prognostic factors, treatment
Published in DiRROS: 10.06.2024; Views: 123; Downloads: 36
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Mesenteric ischemia after capecitabine treatment in rectal cancer and resultant short bowel syndrome is not an absolute contraindication for radical oncological treatment
Ana Perpar, Erik Brecelj, Nada Rotovnik-Kozjek, Franc Anderluh, Irena Oblak, Marija Skoblar Vidmar, Vaneja Velenik, 2015, other scientific articles

Abstract: Thrombotic events, arterial or venous in origin, still remain a source of substantial morbidity and mortality in cancer patients. The propensity for their development in oncology patients is partially a consequence of the disease itself and partially a result of our attempts to treat it. One of the rarest and deadliest thromboembolic complications is arterial mesenteric ischemia. The high mortality rate is caused by its rarity and by its non-specific clinical presentation, both of which make early diagnosis and treatment difficult. Hence, most diagnoses and treatments occur late in the course of the disease. The issue survivors of arterial mesenteric ischemia may face is short bowel syndrome, which has become a chronic condition after the introduction of parenteral nutrition at home. We present a 73-year-old rectal cancer patient who developed acute arterial mesenteric thrombosis at the beginning of the pre-operative radiochemotherapy. Almost the entire length of his small intestine, except for the proximal 50 cm of it, and the ascending colon had to be resected. After multiorgan failure his condition improved, and he was able to successfully complete radical treatment (preoperative radiotherapy and surgery) for the rectal carcinoma, despite developing short bowel syndrome (SBS) and being dependent upon home-based parenteral nutrition to fully cover his nutritional needs. Mesenteric ischemia and resultant short bowel syndrome are not absolute contraindications for radical oncological treatment since such patients can still achieve long-term remission.
Keywords: acute mesenteric ischemia, capecitabine, multiorgan failure, rectal cancer, short bowel syndrome
Published in DiRROS: 23.04.2024; Views: 210; Downloads: 56
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Capecitabine in adjuvant radiochemotherapy for gastric adenocarcinoma
Irena Oblak, Marija Skoblar Vidmar, Franc Anderluh, Vaneja Velenik, Ana Jeromen, Jasna But-Hadžić, 2014, original scientific article

Abstract: Background. In patients with non-metastatic gastric cancer surgery still remains the treatment of choice. Postoperative radiochemotherapy with 5-fluorouracil and leucovorin significantly improves the treatment outcome. The oral fluoropyrimidines, such as capecitabine, mimic continuous 5-fluorouracil infusion, are at least as effective as 5-fluorouracil, and such treatment is more comfortable for the patients. Patients and methods. In the period from October 2006 to December 2009, 101 patients with gastric cancer in stages Ib-IIIc were treated with postoperative chemoradiation with capecitabine. Distal subtotal resection of the stomach was performed in 46.3%, total resection in 50.5% and multivisceral resection in 3.2% of patients. The main endpoints of this study were loco-regional control (LRC), disease-free survival (DFS), disease-specific survival (DSS) and overall survival (OS). The rates of acute side-effects were also estimated. Results. Seventy-seven percent of patients completed the treatment according to the protocol. The median followup time of all patients was 3.9 years (range: 0.4-6.3 years) and in survivors it was 4.7 years (range: 3.2-6.3 years). No death occurred due to the therapy. Acute toxicity, such as nausea and vomiting, stomatitis, diarrhoea, hand-foot syndrome and infections of grade 3 or 4, occurred in 5%, 1%, 2%, 8.9% and 18.8% of patients, respectively. On the close-out date 63.4% patients were still alive and with no signs of the disease. The 4-years follow-up survey showed that LRC, DFS, DSS and OS were 95.5%, 69.2%, 70.7%, and 66.2%, respectively. Higher pN-stage and splenectomy were found to be independent prognostic factors for all four types of survival and perineural invasion and lower treatment intensity for DFS, DSS and OS.
Keywords: gastric cancer, adjuvant therapy, radiochemotherapy
Published in DiRROS: 11.04.2024; Views: 229; Downloads: 64
.pdf Full text (519,56 KB)

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