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Abstract: Background Protein S (PS) is a cofactor of protein C (PC) which, when activated to activated PC (APC), mainly acts to degrade coagulation factor Va and VIIIa, and its deficiency may trigger an array of venous thromboembolic events (VTE); when unprovoked and life-threatening, these need indefinite anticoagulation. Direct oral anti coagulants (doac) are efficient drugs in therapy and prevention of VTE, although the optimal prophylactic doses in different conditions are not identified. Methods General characteristics and clinical events of 33 PS deficient patients (7 uneventful, 10 carrying also other thrombophilic conditions) were recorded from their medical records. Patients suffering from VTE underwent LMWH/Fondaparinux therapy followed by a full dose of doac (apixaban or rivaroxaban) and then a reduced dose doac (apixaban and rivaroxaban). Results Average, lowest and highest PS levels measured during follow-up were higher in male patients (p = 0.001). The cumulative prevalence of patients taking drugs acting on central nervous system (opioids, antidepressants, antiepileptic, antimigraine, antipsychotic) was 33%. Three minor hemorrhages were observed during the full-dose and one during the reduced doac therapy, while 3 VTE (1 pulmonary embolism and 2 deep venous thrombosis) occurred exclusively during the reduced-dose doac therapy (p = 0.033 Vs Full dose, 8.1 100patient/yr 95% CI 4–15). Compliance during the reduced-dose therapy was good according to the circulating levels of doac. In survival analysis, the only variable associated with VTE recurrence was PS deficiency combined with thrombophilic defects (p = 0.049). Conclusions Free PS deficiency affects the quality of life in many ways and a low dose doac in PS deficient patients is only partially effective in secondary prevention of VTE.
Keywords: thrombophilia, reduced-dose DOAC, bleeding, thromboembolic events
Published in DiRROS: 16.04.2026; Views: 186; Downloads: 110
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Abstract: Venous leg ulcers (VLUs) are the most severe complication caused by the progression of chronic venous insufficiency. They account for approximately 70–90% of all chronic leg ulcers (CLUs). A total of 1% of the Western population will suffer at some time in their lives from a VLU. Furthermore, most CLUs are VLUs, defined as chronic leg wounds that show no tendency to heal after three months of appropriate treatment or are still not fully healed at 12 months. The essential feature of VLUs is their recurrence. VLUs also significantly impact quality of life and could cause social isolation and depression. They also have a significant avoidable economic burden. It is estimated that the treatment of venous ulceration accounts for around 3% of the total expenditure on healthcare. A VLU-free world is a highly desirable aim but could be challenging to achieve with the current knowledge of the pathophysiology and diagnostic and therapeutical protocols. To decrease the incidence of VLUs, the long-term goal must be to identify high-risk patients at an early stage of chronic venous disease and initiate appropriate preventive measures. This review discusses the epidemiology, socioeconomic burden, pathophysiology, diagnosis, modes of conservative and invasive treatment, and prevention of VLUs.
Keywords: venous ulcer, recurrent venous ulcer, compression therapy, conservative treatment, invasive treatment, costs, prevention, burden of illness
Published in DiRROS: 24.02.2026; Views: 316; Downloads: 181
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Abstract: Four Slovenian barley samples were analyzed for the content of the ash, proteins, β-glucans and total polyphenols; and for the antioxidant capacity by two methods. Antioxidant capacity was determined by the ferric reducing antioxidant power (FRAP) activity and by the oxygen radical absorbance capacity (ORAC) assay. For the comparison, four foreign barley commercial samples were analyzed, three of German origin and one from Italy. Slovenian samples had equal or lower content of ash, proteins and β-glucans in comparison to foreign samples. A Slovenian barley sample from Šalovci, Prekmurje had the highest content of β-glucans, namely 5.73% in dry weight (DW). The results obtained by both methods of the determination of antioxidant capacity showed significant correlation with the total polyphenols content.
Keywords: Hordeum, barley, beta-glucans, phenols
Published in DiRROS: 29.01.2026; Views: 348; Downloads: 275
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Keywords: socioeconomic development, forest resources, forest ecosystems, forest degradation, forest landscape restoration, forest fire management, urban forests, peri-urban areas, sustainable forest management, Mediterranean region
Published in DiRROS: 09.01.2026; Views: 605; Downloads: 451
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Abstract: Objective: Lipodystrophy syndromes comprise a group of rare diseases characterized by loss of adipose tissue without nutritional or catabolic causes. As the rarity of these conditions necessitates collaboration, the European Consortium of Lipodystrophies (ECLip) established an international, longitudinal registry for patients with all forms of lipodystrophy (excluding HIV-associated cases). Methods: From December 2017 to November 2023, 19 centres from 13 countries recruited 631 patients into the ECLip registry. Cross-sectional data were analysed using descriptive statistics. Results: Prospective data was available for 467 patients (82.7%, female; 86.5% adults; median age 44.0 years). Familial partial lipodystrophy (FPLD) was the most common subtype (57.4%), especially FPLD2 (37.9%). However, in men congenital generalized lipodystrophy was nearly as common as FPLD (33.3% vs. 35.8%). Symptoms at onset varied by subtype, with loss of adipose tissue being the most frequent. More than 70% of the patients suffered from metabolic complications, particularly dyslipidaemia (59.0%) and diabetes (48.4%) but prevalence and severity varied between subtypes (prevalence of diabetes for example 76.9% in patients with acquired partial lipodystrophy vs 8.7% in acquired localized lipodystrophy). Metreleptin, the only disease-specific treatment, was used by 11.6% of all patients. 34 deaths were documented, primarily due to cardiovascular events and cancer. Patients with generalized forms of lipodystrophy died earlier compared to patients with partial forms (median age at death 27.0 vs. 72.0 years). Conclusion: This study describes the largest cohort of patients with lipodystrophy reported to date. The dataset offers a comprehensive view of the epidemiology, clinical presentation, and associated comorbidities of lipodystrophy.
Keywords: lipodystrophy, registry, metabolic diseases, chronic complications, adipose tissue, leptin
Published in DiRROS: 12.12.2025; Views: 378; Downloads: 257
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