91. Pro-inflammatory markers as predictors of arterial thrombosis in aged patients with peripheral arterial disease post revascularizationAdriana A. Rodriguez Alvarez, Isabella F. Cieri, Mounika Naidu Boya, Shiv Patel, Aniket Agrawal, Sasha P. Suarez Ferreira, Christianah Alli, Shruti Sharma, Anahita Dua, 2025, original scientific article Abstract: Introduction: Inflammation occurs in the initial stage of arterial atherosclerosis and serves as the first step in thrombus generation, with elevated inflammatory markers predicting myocardial infarction in coronary artery disease patients. Inflammation is known to alter the course of multiple diseases and can thus, also impact recovery post-treatment and surgical outcomes. Yet, there is a paucity of data regarding the relationship between inflammatory biomarkers and arterial thrombotic potential in peripheral artery disease (PAD) patients post-revascularization. Our pilot study attempts to fill this gap by evaluating if the expression of inflammatory biomarkers in PAD patients correlates with the incidence of thrombotic events post-revascularization. Methods: Plasma samples were prospectively collected from PAD patients who underwent revascularization from 2021 to 2023 at monthly time points for 6 months from the procedure. Patients were followed for a total of 6 months post-procedure and those who experienced thrombotic events were identified. Nine patients with thrombotic events and 16 with non-thrombotic events along with 5 healthy volunteers were analyzed. Plasma samples were analyzed for the following pro-inflammatory markers: IL-1β (Interleukin-1 beta), IL-6, and TNF-α (Tumor Necrosis Factor - alpha), GM-CSF (Granulocyte-Macrophage Colony-Stimulating Factor), IFNγ (Interferon-gamma), IL-8, MCP-1 (Monocyte Chemoattractant Protein-1). The Kruskal-Wallis test was performed to compare bio-inflammatory marker levels between groups. Results: A total of 303 patients were enrolled, of which 59 had thrombotic events. There were no differences between medications or disease burden between groups. Levels of circulating IL-6 and TNF- α were significantly higher in the thrombosis cohort compared to the non-thrombosis cohort (55 vs. 38, p < 0.02) and (159 vs. 110, p < 0.02) respectively. Although there was a trend toward significance for IL-1β between the thrombotic cohort and non-thrombotic cohort, it did not reach statistical significance (18 vs. 11.5, p = NS). There was no difference observed in aspirin's ability to dampen the inflammatory response between the two groups as all patients were on aspirin between the groups evaluated. Conclusion: Pro-inflammatory markers IL-6 and TNF-α are significantly increased in patients, 1 month prior to an arterial thrombotic event, as compared to patients without thrombotic events. These biomarkers could predict impending thrombosis in patients with PAD post-revascularization.
Keywords: inflammation, interleukin-6, peripheral artery disease (PAD), thrombosis, tumor necrosis factor-alpha
Published in DiRROS: 11.12.2025; Views: 66; Downloads: 36
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92. The incidence of pulmonary hypertension and the association with bronchopulmonary dysplasia in preterm infants of extremely low gestational age : single centre study at the Maternity Hospital of University Medical Centre Ljubljana, SloveniaTomaž Križnar, Štefan Grosek, Tina Perme, 2025, original scientific article Abstract: Background: Pulmonary hypertension (PH) occurs in ~25% of infants with moderate-tosevere bronchopulmonary dysplasia (BPD) and is associated with substantial morbidity and mortality. The American Heart Association and American Thoracic Society recommend routine echocardiographic screening for PH in preterm infants with BPD at 36 weeks’ postmenstrual age (PMA), yet the true incidence remains unclear owing to non-uniform diagnostic criteria. Emerging evidence suggests a potential role for earlier screening. Objectives: (i) to determine the incidence of pulmonary hypertension (PH) and bronchopulmonary dysplasia (BPD) in preterm infants of extremely low gestational age; (ii) to determine the incidence of PH among infants diagnosed with BPD (BPD-PH); and (iii) to evaluate the utility of early screening at 7 days of life and late screening at discharge in relation to subsequent BPD. Methods: We conducted a prospective cohort study of all infants born at 22 + 0 to 28 + 6 weeks’ gestation and admitted to our tertiary NICU between 1 September 2022 and 31 December 2024. Clinical and echocardiographic assessments for PH and BPD were performed by neonatologists trained in neonatal echocardiography. Results: Seventy-eight infants born at 22 + 0–28 + 6 weeks’ gestation were enrolled 71 underwent early screening and 57 underwent late screening. Early echocardiography at day 7 and late screening at discharge identified no cases of PH. PH was diagnosed clinically and/or echocardiographically in 10 infants before day 7 and in one infant at 38 weeks’ PMA. BPD developed in 42 of 57 infants (73.7%). Conclusions: In this cohort of extremely lowgestational-age infants, echocardiographic screening performed by neonatologists detected no PH at day 7 and only one case at late screening (at 38 weeks’ PMA/before discharge). Most PH was identified prior to day 7 on clinical and/or echocardiographic grounds
Keywords: pulmonary hypertension (PH), bronchopulmonary dysplasia (BPD), BPD-associated pulmonary hypertension (BPD-PH), extremely low gestational age newborns (ELGANs), echocardiographic screening
Published in DiRROS: 11.12.2025; Views: 79; Downloads: 34
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93. Modified unipolar return pulsed field ablation in ventricular myocardiumMaria Terricabras Casas, Peter Lombergar, Terenz Escartin, Bor Kos, Philippa R. Krahn, Jennifer Barry, Graham Wright, Tomaž Jarm, Jernej Štublar, Matej Kranjc, Nicolas Coulombe, Lars M. Mattison, Daniel C. Sigg, Damijan Miklavčič, Atul Verma, 2025, original scientific article Abstract: BACKGROUND: Various pulsed field ablation (PFA) parameters have been proposed to improve lesion depth. This study evaluated a modified unipolar return PFA system to create deep lesions in healthy and infarcted ventricular myocardia. METHODS: Numerical modeling was used to compare a modified unipolar return PFA system configuration with a conventional unipolar return (skin patch). We then performed ablation in 14 swine (5 with chronic myocardial infarction and 9 healthy). PFA lesions were created in the left ventricle using a focal catheter (4-mm tip) with a return electrode positioned in the inferior vena cava (biphasic, microsecond pulses of 1300 and 1500 V, 1–16 trains). Electroanatomical mapping guided ablation and lesion localization on magnetic resonance imaging were performed 48 hours post-ablation in the infarcted group and at 1 day, 7 days, and 6 weeks post-ablation in the healthy group. RESULTS: Numerical modeling demonstrated that the modified unipolar return PFA system produced deeper lesions with reduced variability compared with the skin patch. In healthy pigs (n=35 lesions), depths of 6.8±1.8 mm and widths of 11.5±4.7 mm were achieved with 8 pulse trains. Depths of 8.2±2.8 mm and widths of 14.0±4.7 mm were achieved with 16 trains. The maximum lesion depths were 8.8 and 11.6 mm for 8 and 16 trains, respectively. In the infarcted cohort (n=22 lesions), all lesions applied to scar tissue penetrated through fibrotic regions, with epicardial involvement observed in 57% of lesions. CONCLUSIONS: The modified unipolar return PFA system effectively creates large lesions and can achieve transmurality in healthy and infarcted animals. Compared with conventional unipolar, it may offer greater lesion depth, width, and consistency. GRAPHIC ABSTRACT: A graphic abstract is available for this article.
Keywords: atrial fibrillation, catheter ablation, heart ventricles, pulmonary veins, tachycardia ventricular
Published in DiRROS: 11.12.2025; Views: 80; Downloads: 44
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94. Sudden death of a four-day-old newborn due to mitochondrial trifunctional protein/long-chain 3-hydroxyacyl-coa dehydrogenase deficiencies and a systematic literature review of early deaths of neonates with fatty acid oxidation disordersAna Drole Torkar, Ana Klinc, Žiga Iztok Remec, Branislava Ranković, Klara Bartolj, Sara Bertok, Sara Colja, Vanja Čuk, Maruša Debeljak, Eva Kozjek, Barbka Repič-Lampret, Matej Mlinarič, Tinka Mohar Hajnšek, Daša Perko, Katarina Štajer, Tine Tesovnik, Domen Trampuž, Blanka Ulaga, Jernej Kovač, Tadej Battelino, Mojca Žerjav-Tanšek, Urh Grošelj, 2025, review article Abstract: Mitochondrial trifunctional protein (MTP) and long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) deficiencies have been a part of the Slovenian newborn screening (NBS) program since 2018. We describe a case of early lethal presentation of MTPD/LCHADD in a term newborn. The girl was born after an uneventful pregnancy and delivery, and she was discharged home at the age of 3 days, appearing well. At the age of 4 days, she was found without signs of life. Resuscitation was not successful. The NBS test performed using tandem mass spectrometry (MS/MS) showed a positive screen for MTPD/LCHADD. Genetic analysis performed on a dried blood spot (DBS) sample identified two heterozygous variants in the HADHA gene: a nucleotide duplication introducing a premature termination codon (p.Arg205Ter) and a nucleotide substitution (p.Glu510Gln). Post-mortem studies showed massive macro-vesicular fat accumulation in the liver and, to a smaller extent, in the heart, consistent with MTPD/LCHADD. A neonatal acute cardiac presentation resulting in demise was suspected. We conducted a systematic literature review of early neonatal deaths within 14 days postpartum attributed to confirmed fatty acid oxidation disorders (FAODs), which are estimated to account for 5% of sudden infant deaths. We discuss the pitfalls of the NBS for MTPD/LCHADD.
Keywords: FAOD, LCHAD deficiency, LCHADD, MTP deficiency, MTPD, NBS, fatty acid oxidation disorder, newborn, newborn screening, sudden infant death
Published in DiRROS: 11.12.2025; Views: 79; Downloads: 46
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96. Subjective well-being and its predictors in Parkinson's disease and dystonia : a comparative studySuzette Shahmoon, Dejan Georgiev, Paul Jarman, Kailash P. Bhatia, Patricia Limousin, Marjan Jahanshahi, 2025, original scientific article Abstract: Background: Quality of life (QoL) is a commonly used outcome measure in people with chronicneurological diseases (CND). As valuable as QoL is, it does not take into account aspects of subjective well-being (SWB) such as subjective happiness, meaning in life, life satisfaction and hope; all constructs that areconsidered central to well-being.ObjectivesObjectives: The goal was to assess how the different aspects of SWB are altered in Parkinson’s disease(PD) and dystonia relative to healthy controls (HCs) and to identify the most important predictors of differentdimensions of SWB in PD and dystonia.MethodsMethods: Eighty-two people with PD, 63 with dystonia, and 50 HCs were surveyed using various measuresof SWB.ResultsResults: People with PD and dystonia had significantly lower satisfaction with life than HCs, with self-esteemand loneliness being significant covariates. Although people with PD and dystonia had significantly lessmeaning in life, they still sought meaning in life as much as HCs. Self-esteem, resilience and neuroticism weresignificant covariates for the presence of “meaning in life.” There were no significant group differences insubjective happiness or hope. In people with PD, mood (depression and anxiety), personality traits (extraversionand self-esteem), disease duration, and pain/discomfort were significant predictors of various measures ofSWB. The main significant predictor of SWB in dystonia was depression, which predicted 49% of the variance insubjective happiness.ConclusionsConclusions: These results emphasize the importance of SWB as a field of investigation and clinical care in themanagement of people with PD and dystonia
Keywords: dystonia, Parkinson's disease, positive psychology, self-esteem, subjective well-being
Published in DiRROS: 10.12.2025; Views: 94; Downloads: 49
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99. Uncovering early predictors of cerebral palsy through the application of machine learning : a case–control studySara Rapuc, Blaž Stres, Ivan Verdenik, Miha Lučovnik, Damjan Osredkar, 2024, original scientific article Abstract: Objective Cerebral palsy (CP) is a group of neurological disorders with profound implications for children’s development. The identification of perinatal risk factors for CP may lead to improved preventive and therapeutic strategies. This study aimed to identify the early predictors of CP using machine learning (ML). Design This is a retrospective case–control study, using data from the two population-based databases, the Slovenian National Perinatal Information System and the Slovenian Registry of Cerebral Palsy. Multiple ML algorithms were evaluated to identify the best model for predicting CP. Setting This is a population-based study of CP and control subjects born into one of Slovenia’s 14 maternity wards. Participants A total of 382CP cases, born between 2002 and 2017, were identified. Controls were selected at a control-to-case ratio of 3:1, with matched gestational age and birth multiplicity. CP cases with congenital anomalies (n=44) were excluded from the analysis. A total of 338CP cases and 1014 controls were included in the study. Exposure 135 variables relating to perinatal and maternal factors. Main outcome measures Receiver operating characteristic (ROC), sensitivity and specificity. Results The stochastic gradient boosting ML model (271 cases and 812 controls) demonstrated the highest mean ROC value of 0.81 (mean sensitivity=0.46 and mean specificity=0.95). Using this model with the validation dataset (67 cases and 202 controls) resulted in an area under the ROC curve of 0.77 (mean sensitivity=0.27 and mean specificity=0.94). Conclusions Our final ML model using early perinatal factors could not reliably predict CP in our cohort. Future studies should evaluate models with additional factors, such as genetic and neuroimaging data
Keywords: early predictors, cerebral palsy
Published in DiRROS: 10.12.2025; Views: 108; Downloads: 48
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100. Systemic auto-inflammatory manifestations in patients with spondyloarthritisCarla Gaggiano, Mojca Zajc Avramovič, Antonio Vitale, Nina Emeršič, Jurgen Sota, Nataša Toplak, Stefano Gentileschi, Valeria Caggiano, Maria Tarsia, Gašper Markelj, Tina Vesel, Anja Koren Jeverica, Tadej Avčin, 2024, original scientific article Abstract: Objectives. – (1) characterizing a group of spondyloarthritis (SpA) patients with systemic autoinflammatory symptoms (S-SpA); (2) comparing SpA features with and without auto-inflammatory symptoms; (3) comparing the auto-inflammatory features of S-SpA and Still’s disease (SD). Methods. – Retrospective observational study. Clinical data of adult and pediatric patients with S-SpA, SD or SpA were collected retrospectively and analyzed. Results. – Forty-one subjects with S-SpA, 39 with SD and 42 with SpA were enrolled. The median latency between systemic and articular manifestations in S-SpA was 4.4 (IQR: 7.2) years. S-SpA and SpA had similar frequency of peripheral arthritis and enthesitis (N.S.), while tenosynovitis was more frequent(P = 0.01) and uveitis less frequent (P < 0.01) in S-SpA. MRI showed signs of sacroiliac inflammation and damage in both S-SpA and SpA equally (N.S.). S-SpA patients had less corner inflammatory lesions (P < 0.05) and inflammation at the facet joints (P < 0.01), more interspinous enthesitis (P = 0.01) and inter-apophyseal capsulitis (P < 0.01). Compared to SD, S-SpA patients had lower-grade fever (P < 0.01), less rash (P < 0.01) and weight loss (P < 0.05), but more pharyngitis (P < 0.01), gastrointestinal symptoms (P < 0.01) and chest pain (P < 0.05). ESR, CRP, WBC, ANC, LDH tested higher in SD (P < 0.01). Resolution of systemic symptoms was less frequent in S-SpA than SD on corticosteroid (P < 0.01) and methotrexate (P < 0.05) treatment. When considering all SD patients, a complete response to corticosteroids in the systemic phase significantly reduced the likelihood of developing SpA (OR = 0.06, coefficient −2.87 [CI: −5.0 to −0.8]). Conclusions. – SpA should be actively investigated in patients with auto-inflammatory manifestations, including undifferentiated auto-inflammatory disease and SD
Keywords: spondyloarthritis, febrile spondyloarthritis, Still’s disease, systemic juvenile idiopathic arthritis, adult-onset Still’s disease, auto-inflammatory diseases
Published in DiRROS: 10.12.2025; Views: 94; Downloads: 37
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