851. Protibolečinsko obsevanje kostnih zasevkovEva Pribožič, Ivica Ratoša, Jasna But-Hadžić, 2023, drugi znanstveni članki Povzetek: Kostni zasevki povzročajo bolečino, ki vpliva na kakovost življenja bolnika in lahko vodijo do zapletov, ki zahtevajo urgentno ukrepanje. Ko zaradi kostnih zasevkov grozi oziroma je prisoten patološki zlom ali maligna kompresija hrbtenjače, je nujno oceniti, ali bolnik potrebuje kirurško intervencijo, ki ji sledi pooperativno obsevanje. Kadar bolnik ni kandidat za operativno zdravljenje, se priporoča urgentno obsevanje. Pri bolečih kostnih zasevkih, brez grozečega oziroma prisotnega patološkega zloma ali maligne utesnitve hrbtenjače, ne glede na velikost samega zasevka, prvi pristop zdravljenja bolečine predstavlja farmakološko zdravljenje, ki ga podpre in dopolni protibolečinsko paliativno obsevanje. Pri paliativnem obsevanju so celokupne obsevalne doze nizke, obsevanje je izvedeno v enem odmerku ali v kratkih obsevalnih režimih. Bolniki, ki ne odgovorijo na prvo obsevanje, ali se jim bolečina ponovi, so lahko varno ponovno obsevani na istem mestu. Na Onkološkem inštitutu Ljubljana smo opravili retrospektivni pregled paliativnih obsevanj kosti med leti 2018 – 2021. Letno obsevamo 800 kostnih zasevkov, upažamo pa upad števila obsevanj. Najpogostejša frakcionacija je 5 x 4 Gy, samo 10% bolnikov pa prejme obsevanje v enem odmerku. Protibolečinsko obsevanje kosti je učinkovito, stroškovno učinkovito in varno. Pomembno je prepoznati bolnike, ki bi imeli korist od protibolečinskega obsevanja, in jih napotiti na konzilij. S poenostavitvijo radioterapevtskih postopkov in odločitvijo za obsevanje v enem odmerku, je lahko obsevalno zdravljenje bolniku prijaznejše in dostopnejše.
Ključne besede: kostni zasevki, bolečina, paliativno obsevanje, frakcionacija
Objavljeno v DiRROS: 26.02.2024; Ogledov: 235; Prenosov: 57
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852. Incidenca raka v prvem letu epidemije covida-19Vesna Zadnik, Tina Žagar, Nika Bric, Mojca Birk, Amela Duratović Konjević, Ana Mihor, Katarina Lokar, Sonja Tomšič, 2023, strokovni članek Povzetek: Uvod: Število novih diagnoz raka (incidenca) se v Sloveniji v zadnjem desetletju povečuje za povprečno 1,6 % na leto. V letu 2020, prvem letu omejitvenih ukrepov zaradi epidemije covida19, smo s platformo OnKOvid predvideli 3–8-odstotni padec novih diagnoz raka. Namen je predstaviti uradno incidenco raka za Slovenijo za leto 2020 in ugotoviti, kolikšen je bil dejansko manko novih diagnoz raka. Metode: V Registru raka Republike Slovenije smo v skladu z mednarodnimi pravili registrirali vse nove primere raka pri prebivalcih s stalnim prebivališčem v Sloveniji. Primerjali smo jih z registrirano incidenco za 2019, modelno incidenco za 2020, preliminarnimi rezultati OnKovida in dostopnimi rezultati incidence iz registrov raka iz drugih držav. Rezultati: V letu 2020 je za rakom zbolelo 15.096 oseb v Sloveniji (7.034 žensk, 8.002 moška). Glede na modelno oceno incidence za leto 2020 gre za manko 1.854 oseb (10,9 %; 11,6 % žensk, 10,4 % moških). Pri tem je za 10,5 % manj ugotovljenih rakov v omejenem stadiju, najbolj izrazito v starosti 50–69 let (za 13,2 %). Upad je primerljiv s poročili iz Anglije, ZDA in Kanade ter deloma večji kot na Škotskem in Švedskem. Najbolj izrazit upad novih diagnoz raka ugotavljamo pri nemelanomskem kožnem raku (23 %, najbolj po 50. letu), raku prostate (15,9 %, najbolj v omejenem stadiju), pljučnem raku (8,9 %, 60–64 let, v razširjenem stadiju), raku dojk (8,3 %, 45–64 let), ne-Hodgkinovem limfomu (9 %) in levkemijah (11,6 %). Pri kožnem melanomu, raku debelega črevesa in danke ni bilo primanjkljaja. Zaključek: Upad incidence raka v letu 2020 gre verjetno na račun omejitvenih ukrepov, reorganizacije zdravstva in z zdravjem povezanega vedenja med epidemijo covida-19, beležijo jo v več državah. Med epidemijami je potrebno nemoteno izvajanje onkologije.
Ključne besede: rak, incidenca, register raka, epidemija, covid-19
Objavljeno v DiRROS: 26.02.2024; Ogledov: 231; Prenosov: 54
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853. Uporaba deksmedetomidina za paliativno sedacijo : prikaz primeraIztok Potočnik, Branka Stražišar, 2023, strokovni članek Povzetek: Paliativna oskrba ob koncu življenja, v katerem se pojavijo znaki pričetka umiranja s pešanjem vitalnih organov in se končajo s smrtjo, je pomemben del celostne paliativne oskrbe. Včasih, ob izredno težkih refraktarnih simptomih napredovale bolezni, je lahko primerna tudi paliativna sedacija. Paliativna sedacija je medicinski postopek, kjer je potrebno strogo upoštevati protokol izvedbe, in slediti etično moralnim vidikom in nikakor prekoračiti črte evtanazije. Paliativno sedacijo je potrebno skrbno načrtovati, se pogovoriti z bolnikom, svojci in s celotnim timom, ki bolnika oskrbuje (zdravniki in negovalno osebje), ga ustrezno dokumentirati in nadzorovati. Pomemben je multidisciplinarni pristop, ko vsak od vključenih zdravnikov specialistov in negovalnega osebja osvetli svoj vidik. V prispevku smo opisali klinični primer bolnice, ki se je zaradi refraktarnega simptoma sprva odločila za paliativno sedacijo, kasneje pa je svojo odločitev spremenila. Pri opisanem primeru s standardnimi učinkovinami sprva nismo uspeli doseči ustrezne globine paliativne sedacije, zato smo se odločili uporabiti deksmedetomidin. Z deksmedetomidinom smo dosegli plitvo sedacijo, ki je bolnici olajšala trpljenje do te mere, da se je tudi odločila za prekinitev paliativne sedacije. Deksmedetomidin je učinkovita in varna učinkovina, ki si išče svoje mesto tudi v paliativni medicini. V literaturi so objavljeni samo posamezni prikazi kliničnih primerov in pregledov področja, ni pa še objavljene randomizirane raziskave. V prihodnosti se taka raziskava načrtuje
Ključne besede: umirajoči bolniki, pozna paliativna oskrba, paliativna sedacija, multidisciplinarni pristop
Objavljeno v DiRROS: 26.02.2024; Ogledov: 249; Prenosov: 64
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856. A critical appraisal of the use and properties of nickel–titanium dental alloysPetra Močnik, Tadeja Kosec, 2021, pregledni znanstveni članek Povzetek: Nickel–titanium (NiTi) archwires are used in dentistry for orthodontic treatment. NiTi alloys have favourable mechanical characteristics, such as superelasticity and shape memory, and are also known as a corrosion-resistant alloy. In specific cases, an archwire could be attacked by certain types of corrosion or wear degradation, which can cause the leaching of metal ions and a hypersensitive response due to increased concentrations of Ni in the human body. A systematic search of the literature retrieved 102 relevant studies. The review paper focuses on three main fields: (i) electrochemical properties of NiTi wires and the effect of different environments on the properties of NiTi wires (fluoride and low pH); (ii) tribocorrosion, a combination of chemical and mechanical wear of the material, and (iii) the biocompatibility of NiTi alloy and its subsequent effect on the human body. The review showed that corrosion properties are affected by microstructure, pH of saliva and the presence of fluorides. A high variation in published results should be, therefore, interpreted with care. The release of nickel ions was assessed using the same unit, showing that the vast majority of metal ions were released in the first few days of exposure, then a stable, steady state was reached. In tribocorrosion studies, the increased concentrations of Ni ions were reported.
Ključne besede: NiTi alloy, archwires, corrosion, NI ion release
Objavljeno v DiRROS: 23.02.2024; Ogledov: 293; Prenosov: 122
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Gradivo ima več datotek! Več... |
857. Real-time monitoring and analyses of sensory data integrated into the bim platformStanislav Lenart, Veljko Janjić, Uros Jovanovic, Rok Vezočnik, 2021, objavljeni znanstveni prispevek na konferenci Povzetek: Bridges and tunnels, crucial elements of the railway infrastructure, are exposed to various types of deterioration processes. Their condition is a subject of monitoring, as it is important to collect as much as possible information in every life cycle phase to reliably predict their future performance. An enormous quantity of monitoring data is generated during the whole life cycle of these assets. EU funded Shift2Rail research project Assets4Rail which is focusing on measuring, monitoring, and data handling for railway assets, as data management is as important as their generation. This paper presents the major outcomes of the Assets4Rail project and its application to infrastructure projects.
Ključne besede: monitoring, information management, BIM, information management, bridge, tunnel, Assets4Rail
Objavljeno v DiRROS: 23.02.2024; Ogledov: 263; Prenosov: 194
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Gradivo ima več datotek! Več... |
858. Cardiac tamponade as the initial manifestation of pulmonary adenocarcinoma : prikaz primera in pregled literatureMitja Letonja, Andrej Debeljak, 2007, strokovni članek Povzetek: Background. Neoplastic pericarditis can be presented as acute pericarditis, pericardial effusion, effusive-constrictive pericarditis or cardiac tamponade.For the majority of patients, a clinical manifestation of neoplasticpericarditis is absent or remains unrecognised during their life. Case report. A 69-year-old non-smoking woman with acute dyspnoea, tachycardia,jugular venous distension, hepatomegaly and right side pleural effusion was presented in the emergency department. The roentgen picture of the chest confirmed pleural effusion and revealed enlarged heart. An emergencyechocardiogram established the diagnosis of cardiac tamponade. The patient improved immediately after the therapeutic pericardiocentesis. Cytology of pericardial fluid confirmed malignant glandular cells, consistent with metastatic adenocarcinoma. A computed chest tomography showed a right side pleural effusion and a solitary round lesion in the right lower lobe of the lung. Bronchoscopy with fundoscopic lung biopsy and brushing revealed adenocarcinoma. Conclusions. Cardiac tamponade as the initial manifestation ofmalignancy is rare and rare is also malignant pericardial effusion due the adenocarcinoma of the lung in a non-smoking woman. The presented patient had one of the longest survival reported in literature despite a limited life expectancy regardless of the treatment in the patient presented with neoplastic pericarditis.
Objavljeno v DiRROS: 22.02.2024; Ogledov: 288; Prenosov: 46
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859. Quality of life following thoracotomy for lung cancerLučka Debevec, Irma Rozman Sinur, 2007, izvirni znanstveni članek Povzetek: Background. The aim of the study was to assess the preoperative and postoperative quality of life (QoL) in lung cancer patients undergoing thoracotomy and to compare the impairment of QoL in resected and exploratory thoracotomized (ET) patients. Patients and methods. Forty-three patients age 31 to 82 (mean 61) thoracotomized (lobectomy 29, bilobectomy 1, pneumonectomy 8, ET 5) for non-small cell lung cancer were assessed using the EORTC QLQ-LC30and QLQ-LC13 questionnaire preoperatively and a mean of 45 17 days after the thoracotomy and before eventual chemotherapy and radiation therapy. Results. After thoracotomy there were significantly impaired functional scales(physical functioning, role functioning, social functioning) and symptomscales (fatigue, constipation, appetite loss, dyspnoea, pain). The remaining symptoms (nausea/vomiting, insomnia, diarrhoea, coughing), global health status, functional scales (emotional functioning, cognitive functioning) and financial difficulties were impaired non-significantly. However, haemoptysis significantly improved and completely disappeared after thoracotomy. There were no significant differences between resected and ET patients. Conclusions. The study established significant impairment of QoL in the first two months after thoracotomy, but no significant differences betweenresected and ET patients.
Objavljeno v DiRROS: 22.02.2024; Ogledov: 812; Prenosov: 53
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860. Adjuvant treatment of breast cancer patients with trastuzumabErika Matos, Tanja Čufer, 2007, pregledni znanstveni članek Povzetek: Background. Trastuzumab is a monoclone antibody directed against HER2 receptors that are overexpressed in approximately 20% of breast cancer patients. The present paper presents five clinical trials in which trastuzumabwas applied in breast cancer patients in adjuvant setting. The results of all the trials consistently demonstrate a high efficacy of this target drug in the patients with HER2 positive tumours. So far, no formal guidelines for using trastuzumab in adjuvant setting for breast cancer have been approved. The reasons are many: (i) mean observation time in the studies done so far was considerably short; (ii) the drug was used according to different schedules, (iii) the overall time of treatment with trastuzumab was different in each trial, (iv) late side effects of treatment with trastuzumab are inadequately investigated, and (v) nobody can so far say for sure for which HER2 status patients therapy with trastuzumab is really beneficial. Conclusions. Trastuzumab is definitely very helpful in the treatment of the HER2-positive breast cancer patients that are hormone-independent and of anatomically larger tumours; but, what the absolute benefit of trastuzumab therapy in the treatment of small hormone-dependent tumours is remains a mystery. Incidentally, it must be borne in mind that cardiotoxicity, the well known side effect, may put particularly elderly patients at risk of death, thus beating any treatment advantages down. It has also not been yet resolved at what time it would be most appropriate to start with the therapy with trastuzumab, what would be the optimal duration of the therapy and whether trastuzumab is to be administered concurrently with chemotherapy or immediately after it? What is the optimal treatment duration, one or two yearsor only a few months? In addition there is still a question of optimal HER2 status determination and which HER2 status predicts for trastuzumab benefit. (Abstract truncated at 2000 characters)
Objavljeno v DiRROS: 22.02.2024; Ogledov: 323; Prenosov: 52
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