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Query: "author" (Daša Perko) .

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1.
Obravnava ploda in novorojenčka s cistično fibrozo
Simona Capl, Jasna Rodman, Uroš Krivec, Marina Praprotnik, Aneta Soltirovska Šalamon, Jernej Brecelj, Anja Praprotnik Novak, Anija Orel, Daša Perko, Majda Oštir, Sandra Cerar, 2026, review article

Abstract: Cistična fibroza (CF) je najpogostejša avtosomno recesivna genetska bolezen, pri kateri so prizadeti številni organski sistemi, predvsem dihala, prebavila, endokrini sistem in reproduktivni organi. Določene morfološke spremembe pri plodu lahko odkrijemo že pred rojstvom. Po rojstvu lahko zaradi zapore prebavil ob mekonijskem ileusu pride do življenje ogrožujočih zapletov. Bolezen se najpogosteje klinično izrazi v zgodnjem otroštvu, vendar ima lahko že novorojenček pomanjkljivo delovanje trebušne slinavke. CF pri novorojenčkih odkrivamo s presejalnim testiranjem. Poleg dosedanje obravnave, ki pri bolnikih s CF vključuje respiratorno fizioterapijo, aktivno iskanje in zdravljenje okužb, skrb za primerno prehranjenost ter nadomeščanje encimov, vitaminov in mineralov, pa se je zaradi uvedbe novejših zdravil (modulatorjev regulatorja transmembranske prevodnosti pri CF oz. CFTR modulatorjev) močno spremenil potek bolezni in se izboljšala reproduktivna sposobnost žensk. Ker na potek nosečnosti zaenkrat ni dokazanega pomembnega negativnega vpliva, noseče bolnice pogosto nadaljujejo z zdravljenjem tudi med nosečnostjo. CFTR modulatorji prehajajo preko posteljice in se izločajo z materinim mlekom. Ker je ob odkritju bolezni pri novorojenčku potrebna obravnava, smo izdelali priporočila. V prispevku opisujemo tudi pogled na zdravljenje ploda s CF že prenatalno in obravnavo novorojenčka, ki je bil kot plod izpostavljen zdravilom za CF zaradi zdravljenja matere s CF med nosečnostjo.
Keywords: cistična fibroza, plod, novorojenček, nosečnost, CFTR modulatorji, mekonijski ileus
Published in DiRROS: 06.05.2026; Views: 158; Downloads: 85
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2.
Current status of newborn screening in Southeastern and Central Europe
Nika Požun, Daša Perko, Violeta Anastasovska, Tadej Battelino, Ana Drole Torkar, Matej Mlinarič, Žiga Iztok Remec, Barbka Repič-Lampret, Domen Trampuž, Mojca Žerjav-Tanšek, Urh Grošelj, 2026, original scientific article

Abstract: Newborn screening (NBS) is a well-established public health program that enables early detection and treatment of rare disorders in newborns, preventing severe complications or death. Despite its recognized importance, the scope and implementation of NBS programs vary across Southeastern (SE) and Central Europe. This study aimed to evaluate the current status of NBS in 16 countries of SE and Central Europe and assess progress since the previous survey in 2021. A structured questionnaire was distributed to national experts between April and December 2025, collecting data on program organization, coverage, diseases included, laboratory methods, confirmatory testing, consent practices, and future expansion plans. All countries reported universal screening for congenital hypothyroidism, except Kosovo, where a national NBS is in the process of being established. Expanded NBS using tandem mass spectrometry was available in Austria, Bulgaria, Croatia, Cyprus, Greece, Hungary, North Macedonia, Romania, and Slovenia. Spinal muscular atrophy screening became universal in Austria, Croatia, Hungary, Serbia, and Slovenia. Most countries reported plans for further expansion, with congenital adrenal hyperplasia, severe combined immunodeficiency, spinal muscular atrophy, and cystic fibrosis being the most frequently targeted conditions. Although notable infrastructural progress has been achieved, financial constraints, lack of staff, and organizational barriers remain key challenges. The study’s assessment of program effectiveness was further limited by the absence of region-wide systems for capturing end-to-end performance indicators, such as the age of the infant at treatment initiation or missed cases. Regional collaboration and adoption of best practices are therefore vital to ensure equitable access and continuous advancement of NBS programs.
Keywords: newborn screening, NBS, Southeastern Europe, Central Europe, neonatal screening, expanded NBS program
Published in DiRROS: 06.03.2026; Views: 306; Downloads: 209
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3.
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 disorders
Ana 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: 400; Downloads: 284
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4.
International survey on Phenylketonuria newborn screening
Domen Trampuž, Peter C. J. I. Schielen, Rolf H. Zetterström, Maurizio Scarpa, François Feillet, Viktor Kožich, Trine Tangeraas, Ana Drole Torkar, Matej Mlinarič, Daša Perko, Žiga Iztok Remec, Barbka Repič-Lampret, Tadej Battelino, Urh Grošelj, 2025, original scientific article

Abstract: ewborn screening for Phenylketonuria enables early detection and timely treatment with a phenylalanine-restricted diet to prevent severe neurological impairment. Although effective and in use for 60 years, screening, diagnostic, and treatment practices still vary widely across countries and centers. To evaluate the Phenylketonuria newborn screening practices internationally, we designed a survey with questions focusing on the laboratory aspect of the screening system. We analyzed 24 completed surveys from 23 countries. Most participants used the same sampling age range of 48–72 h; they used tandem mass spectrometry and commercial non-derivatized kits to measure phenylalanine (Phe), and had non-negative cut-off values (COV) set mostly at 120 µmol/L of Phe. Participants mostly used genetic analysis of blood and detailed amino acid analysis from blood plasma as their confirmatory methods and set the COV for the initiation of dietary therapy at 360 µmol/L of Phe. There were striking differences in practice as well. While most participants reported a 48–72 h range for age at sampling, that range was overall quite diverse Screening COV varied as well. Additional screening parameters, e.g., the phenylalanine/tyrosine ratio were used by some participants to determine the screening result. Some participants included testing for tetrahydrobiopterin deficiency, or galactosemia in their diagnostic process. Results together showed that there is room to select a best practice from the many practices applied. Such a best practice of PKU-NBS parameters and post-screening parameters could then serve as a generally applicable guideline.
Keywords: phenylketonuria, newborn, neonatal, screening, international, survey, laboratory, methods, cut-off
Published in DiRROS: 04.12.2025; Views: 2316; Downloads: 291
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