1571. Drug-resistant tuberculosis on the Balkan Peninsula : determination of drug resistance mechanisms with Xpert MTB/XDR and whole-genome sequencing analysisSara Truden, Eva Sodja, Marija Žolnir-Dovč, 2023, original scientific article Abstract: The new molecular assay Xpert MTB/XDR (Cepheid, Sunnyvale, CA, USA) was launched in 2021 to detect Mycobacterium tuberculosis (MT) complex with mutations conferring resistance to isoniazid (INH), ethionamide (ETH), fluoroquinolone (FQ), and second-line injectable drugs (SLIDs). The aim of our study was to evaluate the performance of the Xpert MTB/XDR rapid molecular assay on rifampicin-resistant, multidrug-resistant, and pre-extensively resistant tuberculosis (TB) isolates in a clinical laboratory in the Balkan Peninsula compared to a phenotypic drug susceptibility test (pDST). Xpert MTB/XDR was used to test positive Bactec MGIT 960 (Becton, Dickinson and Co., Franklin Lakes, NJ, USA) cultures or DNA isolates. In the case of discrepant results between Xpert MTB/XDR and pDST, the usefulness of whole-genome sequencing (WGS) was emphasized. In our study, 80 MT isolates from different Balkan countries were selectively chosen from the National Mycobacterial Strain Collection in Golnik, Slovenia. Isolates were tested with the Xpert MTB/XDR assay, conventional pDST, and WGS. Xpert MTB/XDR showed high sensitivities of 91.9%, 100%, and 100% for detecting INH, FQ, and SLID resistance, respectively, compared to pDST. In contrast, low sensitivity (51.9%) for ETH resistance was achieved because isolates harbored widespread mutations across the ethA gene. The specificity of Xpert MTB/XDR was 100% for all drugs except for INH (66.7%). Further investigation with WGS revealed −57c→t mutations in the oxyR-ahpC region marked with uncertain significance, which caused the low specificity for detecting INH resistance with the new assay. Xpert MTB/XDR can be used in clinical laboratories for the rapid detection of INH, FQ, and SLID resistance. Moreover, it can be used to rule in resistance to ETH. Additional use of WGS is recommended in cases of discrepant results between pDST and Xpert MTB/XDR. Future improvements of Xpert MTB/XDR with the inclusion of additional genes may increase the usefulness of the assay.
Keywords: drug resistant tuberculosis, whole-genome sequencing analysis, molecular diagnostics, Xpert MTB/XDR
Published in DiRROS: 18.07.2025; Views: 562; Downloads: 278
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1578. Priporočila za sistemsko onkološko in radioterapevtsko zdravljenje rakov biliarnega traktaErik Brecelj, Martina Reberšek, Ajra Šečerov Ermenc, Vesna Zadnik, Maja Ebert Moltara, Nežka Hribernik, Peter Korošec, Tanja Mesti, Janja Ocvirk, Franc Anderluh, Marko Boc, Marija Ignjatović, Ana Jeromen, Irena Oblak, Vaneja Velenik, Jelena Azarija, Neva Volk, Nena Golob, 2025, professional article Abstract: Raki biliarnega trakta so redka in heterogena skupina z naraščajočo incidenco in visoko umrljivostjo. Imajo slabo prognozo s celokupnim preživetjem manj od 1 leta. Nova dognanja o molekularno genetski heterogenosti rakov biliarnega trakta in novi terapevtskih pristopi omogočajo tem bolnikom daljša preživetja in boljšo kvaliteto življenja. V Priporočilih so predstavljena najnovejša priporočila za sistemsko onkološko zdravljenje in radioterapijo te skupine rakov, med katere po mednarodnih propročilih sedaj prištevamo karcinom žolčnika, intrahepatalne holangiokarcinome in ekstrahepatične holangiokarcinome, s perihilarnim holangiokarcinomom in karcinomom distalnega žolčevoda. Priporočila za sistemsko zdravljenje so povzeta in pripravljena na podlagi mednarodnih priporočil, ameriških, National Comprehensive Cancer Network (NCCN) in evropskih, Evropskega združenja za internistično onkologijo – European Society of Medical oncology (ESMO).
Keywords: raki biliarnega trakta, sistemsko zdravljenje, priporočila
Published in DiRROS: 18.07.2025; Views: 473; Downloads: 192
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1579. Uvealni melanom : priporočila zdravljenjaBarbara Perić, Gregor Hawlina, Vladimir Debelić, Janja Ocvirk, Martina Reberšek, Marko Kokalj, Gaber Plavc, Vesna Zadnik, Alenka Lavrič, 2025, professional article Abstract: Uvealni melanom je najpogostejši primarni maligni znotrajočesni tumor pri odraslih. Med uvealne melanome uvrščamo melanom žilnice (90 %), ciliarnika (6 %) in šarenice (4 %). Med leti 2017 in 2021 je za uvealnim melanomom v Sloveniji letno zbolelo povprečno 23 oseb, kar predstavlja 3,7 % vseh melanomov. Prva slovenska celostna in multidisciplinarna priporočila zdravljenja vključujejo melanome žilnice in ciliarnika in so povzeta po
ameriških smernicah NCCN. Priporočila celostno predstavijo
tako dejavnike tveganja, kot klinično sliko in možnosti lokalnega zdravljenja tega raka, kot tudi sodobne načine multidisciplinarnega zdravljenja oddaljenih zasevkov vključno z možnostjo genotipizacije polne krvi na prisotnost človeškega levkocitnega antigena (HLA)-A*02:01).
S priporočili želimo specialistom različnih strok olajšati tako
pogovor z bolnikom in svojci, kot izbiro ustreznega zdravljenja.
Keywords: uvelani melanom, multidisciplinarno zdravljenje, priporočila
Published in DiRROS: 18.07.2025; Views: 596; Downloads: 159
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1580. Določanje stopnje kristaliničnosti in vpliva na lastnosti filamenta PA6 : diplomsko deloDraginja Talić, 2024, undergraduate thesis Keywords: poliamid 6, filamenti, kristaliničnost, stopnja kristaliničnosti, sposobnost obarvanja, natezne lastnosti, diferenčna dinamična kalorimetrija (DSC), infrardeča spektroskopija s Fourierjevo transformacijo (FTIR), diplomsko delo
Published in DiRROS: 18.07.2025; Views: 531; Downloads: 171
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