1. Modern approach to the management of genitourinary syndrome in women with gynecological malignanciesNina Kovačević, Ines Cilenšek, Sebastjan Merlo, Barbara Šegedin, 2023, pregledni znanstveni članek Povzetek: The term genitourinary syndrome of menopause was first used in 2014 by the North American Menopause Society and the International Society for the Study of Women's Sexual Health to describe conditions previously known as atrophic vaginitis, urogenital atrophy, or vulvovaginal atrophy. It is a complex, chronic, progressive condition characterized by a wide range of signs and symptoms affecting sexual function and the tissues of the urinary and genital tracts. The main cause of genitourinary syndrome of menopause is estrogen deficiency caused by ovarian removal or dysfunction. The most bothersome symptoms are vaginal dryness, decreased vaginal lubrication, and pain during penetration and intercourse. They all have a negative impact on the quality of life. Conclusions: The main goal of treatment is to relieve the symptoms. Treatment modalities are pharmacological or non-pharmacological. The first-line treatment for mild to moderate symptoms is the use of personal lubricants and moisturizers, but the gold standard is estrogen replacement therapy. Hormone therapy may not be an option for women with hormone-dependent cancer.
Ključne besede: genitourinary syndrome, gynecological malignancies, therapy
Objavljeno v DiRROS: 25.07.2024; Ogledov: 99; Prenosov: 31
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2. Treatment of vulvar cancer recurrences with electrochemotherapy : a detailed analysis of possible causes for unsuccessful treatmentGregor Vivod, Tanja Jesenko, Gorana Gašljević, Nina Kovačević, Maša Omerzel, Gregor Serša, Sebastjan Merlo, Maja Čemažar, 2023, izvirni znanstveni članek Povzetek: Background. Electrochemotherapy has good local effectiveness in the treatment of vulvar cancer. Most studies have reported the safety and effectiveness of electrochemotherapy for palliative treatment of gynecological cancers and mostly vulvar squamous cell carcinoma. Some tumors, however, fail to respond to electrochemotherapy. The biological features/determinants for the nonresponsiveness are not determined yet. Patient and methods. A recurrence of vulvar squamous cell carcinoma was treated by electrochemotherapy using intravenous administration of bleomycin. The treatment was performed by hexagonal electrodes according to standard operating procedures. We analyzed the factors that could determine nonresponsiveness to electrochemotherapy. Results. Based on the presented case of nonresponsive vulvar recurrence to electrochemotherapy, we hypothesize that the vasculature of the tumors prior to treatment may predict the response to electrochemotherapy. The histological analysis showed minimal presence of blood vessels in the tumor. Thus, low perfusion may reduce drug delivery and lead to a lower response rate because of the minor antitumor effectiveness of vascular disruption. In this case, no immune response in the tumor was elicited by electrochemotherapy. Conclusions. In this case, of nonresponsive vulvar recurrence treated by electrochemotherapy, we analyzed possible factors that could predict treatment failure. Based on histological analysis, low vascularization of the tumor was observed, which hampered drug delivery and distribution and resulted in no vascular disrupting action of electrochemotherapy. All these factors could contribute to ineffective treatment with electrochemotherapy.
Ključne besede: electrochemotherapy, bleomycin, vulvar cancer
Objavljeno v DiRROS: 25.07.2024; Ogledov: 107; Prenosov: 92
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3. Preoperative serum CA-125 level as a predictor for the extent of cytoreduction in patients with advanced stage epithelial ovarian cancerSebastjan Merlo, Nikola Bešić, Eva Drmota, Nina Kovačević, 2021, izvirni znanstveni članek Povzetek: Background. Ovarian cancer is the seventh most common cancer in women worldwide and the eighth most common cause of cancer death. Due to the lack of effective early detection strategies and the unspecific onset of symptoms, it is diagnosed at an advanced stage in 75% of cases. The cancer antigen (CA) 125 is used as a prognostic marker and its level is elevated in more than 85% of women with advanced stages of epithelial ovarian cancer (EOC). The standard treatment is primary debulking surgery (PDS) followed by adjuvant chemotherapy (ACT), but the later approach is neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS). Several studies have been conducted to find out whether preoperative CA-125 serum levels influence treatment choice, surgical resection and survival outcome. The aim of our study was to analyse experience of single institution as Cancer comprehensive center with preoperative usefulness of CA-125. Patients and methods. At the Institute of Oncology Ljubljana a retrospective analysis of 253 women with stage FIGO IIIC and IV ovarian cancer was conducted. Women were divided into two groups based on their primary treatment. The first group was the NACT group (215 women) and the second the PDS group (38 women). The differences in patient characteristics were compared using the Chi-square test and ANOVA and the Kaplan-Meier method was used for calculating progression-free survival (PFS) and overall survival (OS). Results. The median serum CA-125 level was higher in the NACT group than in the PDS group, 972 IU/ml and 499 IU/ ml, respectively. The PFS in the NACT group was 8 months (95% CI 6.4%9.5) and 18 months (95% CI 12.5%23.4) in the PDS group. The median OS was lower in the NACT group than in the PDS group, 25 months (95% CI 20.6%29.5) and 46 months (95% CI 32.9%62.1), respectively. Conclusions. Preoperative CA-125 cut off value of 500 IU/ml is a promising threshold to predict a successful PDS.
Ključne besede: ovarian cancer, tumour marker, neoadjuvant chemotherapy, CA-125
Objavljeno v DiRROS: 22.07.2024; Ogledov: 87; Prenosov: 25
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4. Surgical treatment and fertility perservation in endometrial cancerNina Kovačević, 2021, pregledni znanstveni članek Povzetek: Endometrial cancer (EC) represents a high health burden in Slovenia and worldwide. The incidence is increasing due to lifestyle and behavioural risk factors such as obesity, smoking, oestrogen exposure and aging of the population. In many cases, endometrial cancer is diagnosed at an early stage due to obvious signs and symptoms. The standard treatment is surgery with or without adjuvant therapy, depending on the stage of the disease and the risk of recurrence. However, treatment modalities have changed in the last decades, considerably in the extent of lymphadenectomy. Conclusions. The gold standard of treatment for is surgery, which may be the only treatment modality in the early stages of low-grade tumours. In recent years, a minimally invasive approach with sentinel node biopsy (SNB) has been proposed. A conservative approach with hormonal treatment is used if fertility preservation is desired. If EC is in advance stage, high-risk histology, or high grade, radiotherapy, chemotherapy, or a combination of both is recommended.
Ključne besede: endometrial cancer, uterus, treatment, minimally invasive surgery
Objavljeno v DiRROS: 22.07.2024; Ogledov: 96; Prenosov: 23
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5. Experimental evidence of long-term oceanic circulation reversals without wind influence in the North Ionian SeaAngelo Rubino, Miroslav Gačić, Manuel Bensi, Vedrana Kovacevic, Vlado Malačič, Milena Menna, Maria Eletta Negretti, Joel Sommeria, Davide Zanchettin, Ricardo V. Barreto, Laura Ursella, Vanessa Cardin, Giuseppe Civitarese, Mirko Orlić, Boris Petelin, Giuseppe Siena, 2020, izvirni znanstveni članek Povzetek: Under the emerging features of interannual-to-decadal ocean variability, the periodical reversals of the North Ionian Gyre (NIG), driven mostly by the mechanism named Adriatic-Ionian Bimodal Oscillating System (BiOS), are known as impacting on marine physics and biogeochemistry and potentially influencing short-term regional climate predictability in the Eastern Mediterranean. Whilst it has been suggested that local wind forcing cannot explain such variability, aspects of the alternative hypothesis indicating that NIG reversals mainly arises from an internal ocean feedback mechanism alone remain largely debated. Here we demonstrate, using the results of physical experiments, performed in the world’s largest rotating tank and numerical simulations, that the main observed feature of BiOS, i.e., the switch of polarity of the near-surface circulation in the NIG, can be induced by a mere injection of dense water on a sloping bottom. Hence, BiOS is a truly oceanic mode of variability and abrupt polarity changes in circulation can arise solely from extreme dense water formation events.
Ključne besede: physical oceanography, climate and Earth system modelling
Objavljeno v DiRROS: 19.07.2024; Ogledov: 109; Prenosov: 93
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6. Risk based life-cycle planning for flood-resilient critical infrastructureSandra Škarić Palić, I. Stipanovic, E. Ganic, Mirko Kosič, Andrej Anžlin, M. Bacic, M. S. Kovacevic, K. Gavin, 2023, objavljeni znanstveni prispevek na konferenci Povzetek: The paper presents a risk assessment model, developed in the project oVER-FLOw and further implemented in the project CROSScade, for determining the direct and indirect impacts of flooding hazards. As a consequence of flooding, transport infrastructure and flood protection systems can be significantly damaged and cause cascading effects on other infrastructure. To achieve flood resilient infrastructure, it is necessary to assess the vulnerability of critical assets in the affected area. The model uses novel vulnerability assessment methods for embankments and bridges exposed to different flood hazard scenarios allowing the asset owners to understand risk and performance of their infrastructure. Scarce financial resources are allocated on the critical assets allowing significant cost savings and avoiding the waste of non-renewable resources in strengthening large sections which have sufficient resilience. The consequence analysis is based on an improved quantification model for direct and indirect impacts of different flood hazard scenarios used for risk mapping of the affected area.
Ključne besede: flooding, risk assessment, critical infrastructure, economic loss
Objavljeno v DiRROS: 23.05.2024; Ogledov: 269; Prenosov: 231
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8. Rak jajčnikov : ponovno nekaj novega2023, zbornik recenziranih znanstvenih prispevkov na domači konferenci Povzetek: Rak jajčnikov je najpogostejši vzrok smrti pri ženskah, ki zbolijo za ginekološkimi raki, saj je bolezen za večino bolnic v napredovalih fazah pogosto usodna. To je posledica težavne prepoznavnosti bolezni v zgodnjih fazah, ko je zdravljenje učinkovito. /// Na žalost preventivni program za zgodnje odkrivanje raka jajčnikov še ne obstaja, zato je pri več kot 75 % bolnic bolezen odkrita v napredovalih stadijih, kar posledično prinaša slabo prognozo. Tako pri zdravnikih kot pri ženskah je pomanjkljivo poznavanje zgodnjih znakov bolezni, kar lahko vodi v napačno diagnostiko in triažiranje bolnic v neprimerno zdravstveno ustanovo. /// Diagnoza se postavi s pomočjo ustreznih diagnostičnih preiskav, potrdi pa se s patohistološko preiskavo. 90 % rakov jajčnikov izvira iz epitelija, medtem ko so drugi tipi redki. Osnovno zdravljenje vključuje kirurški poseg, katerega cilj je popolnoma odstraniti bolezen in doseči stanje brez vidnega ostanka bolezni. Sledi sistemska terapija, medtem ko obsevanje pri zdravljenju raka jajčnikov nima ključnega pomena. /// Ugotovljeno je, da je zdravljenje raka jajčnikov najuspešnejše v specializiranih ustanovah, kjer delujejo strokovnjaki z usmerjenostjo v ginekološko-onkološko področje. V Sloveniji si nenehno prizadevamo za standardizirano in kakovostno obravnavo žensk z rakom jajčnikov.
Ključne besede: ginekološki raki, elektronske knjige
Objavljeno v DiRROS: 22.11.2023; Ogledov: 538; Prenosov: 228
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9. Priporočila za obravnavo bolnikov s pljučnim rakomMartina Vrankar, Nina Boc, Izidor Kern, Aleš Rozman, Karmen Stanič, Tomaž Štupnik, Mojca Unk, Maja Ebert Moltara, Vesna Zadnik, Katja Adamič, Jernej Benedik, Marko Bitenc, Jasna But-Hadžić, Anton Crnjac, Marina Čakš, Dominik Časar, Eva Ćirić, Tanja Čufer, Ana Demšar, Rok Devjak, Goran Gačevski, Marta Globočnik Kukovica, Kristina Gornik-Kramberger, Maja Ivanetič Pantar, Marija Ivanović, Urška Janžič, Staša Jelerčič, Veronika Kloboves-Prevodnik, Mile Kovačević, Luka Ležaič, Mateja Marc-Malovrh, Katja Mohorčič, Loredana Mrak, Igor Požek, Nina Turnšek, Bogdan Vidmar, Dušanka Vidovič, Gregor Vlačić, Ana Lina Vodušek, Rok Zbačnik, Ivana Žagar, 2023, strokovni članek Povzetek: Leta 2019 so bila objavljena Priporočila za obravnavo bolnikov s pljučnim rakom, ki so v slovenski prostor vnesla prepotrebno poenotenje diagnostike in zdravljenja z namenom izboljšanja preživetja bolnikov s pljučnim rakom. Posodobitev Priporočil tri leta po izidu izvirnika prinaša največ novosti v poglavju o sistemskem zdravljenju bolnikov s pljučnim rakom. To kaže na izjemen napredek na področju razumevanja onkogeneze in biologije pljučnega raka ter s tem razvoja novih zdravil. Breme pljučnega raka ostaja veliko, saj je pljučni rak pri nas in v svetu še vedno najpogostejši vzrok smrti zaradi raka. Za vsako peto smrt zaradi raka je odgovoren pljučni rak. Skoraj tretjina bolnikov s pljučnim rakom ne prejme specifičnega onkološkega zdravljenja, bodisi zaradi slabega stanja zmogljivosti, spremljajočih bolezni ali obsega bolezni. Polovica bolnikov ima ob diagnozi razsejano bolezen, zaradi česar izboljšanje preživetja z malimi koraki sledi napredku v zdravljenju bolnikov s pljučnim rakom. Ti podatki nas opominjajo, da se bomo morali za velike premike v obravnavi bolnikov s pljučnim rakom lotiti drugačnih pristopov. Kot najbolj obetavno se ponuja zgodnje odkrivanje bolezni, ko so možnosti ozdravitve pljučnega raka najboljše. Zapisana Priporočila so usmeritev za obravnavo bolnikov s pljučnim rakom. Le s sodobnim multidisciplinarnim pristopom obravnave lahko bolniku ponudimo zdravljenje, ki mu omogoča najboljši izhod prognostično neugodne bolezni.
Ključne besede: pljučni rak, priporočila
Objavljeno v DiRROS: 27.07.2023; Ogledov: 665; Prenosov: 259
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10. Hodgkinov limfom : vodnik za bolnikeBarbara Jezeršek Novaković, Samo Zver, Metka Zajc, Aleksandra Grbič, Andreja Cirila Škufca Smrdel, Eda Vrtačnik-Bokal, Vesna Šalamun, Nina Kovačević, Lorna Zadravec-Zaletel, Matej Pečovnik, 2022, ni določena Ključne besede: rak (medicina), krvotvorne matične celice, transplantacija, psihološka pomoč, plodnost, hormonsko nadomestno zdravljenje
Objavljeno v DiRROS: 24.07.2023; Ogledov: 568; Prenosov: 144
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