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1.
Tensiomyography-derived contractile parameters in sarcopenic and non-sarcopenic older adults
Katarina Puš, Miloš Kalc, Boštjan Šimunič, 2026, original scientific article

Abstract: Background: Sarcopenia, the progressive decline in skeletal muscle mass and function, is a major public health concern linked to falls, hospitalization and loss of independence among older adults. Initially defined by reduced muscle mass, later also by reduced muscle strength and function, it is now recognized that standard diagnostic tools do not fully capture complexity of sarcopenia. Tensiomyography (TMG) is a non-invasive method that assesses skeletal muscle contractile parameters, which undergo change with aging and sarcopenia. The aims of this exploratory study are to determine whether TMG could be a method for contractile parameters assessment in sarcopenia classification and to evaluate the relationship between TMG-derived parameters and sarcopenia classification tests. Methods: We included 654 older adults (70.6% women) and included demographics, sarcopenia classification (EWGSOP2, SDOC), muscle strength (handgrip strength, five sit-to-stand), TMG of three leg muscles, muscle mass (bioimpedance), and physical performance (gait speed, timed up-and-go). MANOVA was used to analyze contractile properties and due to low agreement between classifications, we used both classifications. A partial correlation for each sex was conducted to determine the associations between sarcopenia classification tests and TMG-derived parameters of delay time (Td), contraction time (Tc), radial displacement (Dm) and contraction velocity (Vc), controlling for age. Results: One-way MANOVA confirmed difference between sarcopenic and nonsarcopenic participants according to EWGSOP2 and SDOC classifications in TMG-derived contractile parameters in all three muscles, Td was consistently longer and Dm consistently lower in sarcopenic individuals. Post-hoc univariate tests further demonstrated specific differences due to sarcopenia presence. Ageadjusted partial correlations were weak to moderate, ranging between −0.430 and 0.369. Conclusion: Sarcopenic individuals exhibited longer Td and Tc, and smaller Dm, though not consistently across all muscles. Td was longer in all three muscles, reflecting electromechnical delays linked to aging. Dm was consistently lower, suggesting increased muscle stiffness. Correlations between TMG parameters and sarcopenia classification tests indicated that shorter Td and Tc, higher Dm, and greater Vc were associated with higher muscle volume, muscle strength and performance. The findings indicate that TMG parameters may be associated with neuromuscular degeneration and sarcopenia, supporting further exploration of muscle- and sex-specific differences.
Keywords: tensiomyography, muscle function, older adults, sarcopenia, seniors
Published in DiRROS: 04.02.2026; Views: 117; Downloads: 55
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2.
Helicobacter pylori infection in children Versus adults, differences in management guidelines: risks and benefits of treatment in childhood
Matjaž Homan, Zrinjka Mišak, Francis Megraud, Michal Kori, 2025, original scientific article

Abstract: Helicobacter pylori infection in children and adults differs in several aspects such as the natural history, prevalence, the clinical presentations and complications, antibiotic resistance rates, treatment options, and the success rates of treatment. Due to all the abovementioned differences, management guidelines and recommendations are different between children and adults. In parallel to the steady decrease in the rate of H. pylori infection in the Western world in recent years, both in children and adults, antibiotic resistance rates have risen to alarming rates. The risk and benefits of eradication treatment, especially in children, must be considered when deciding “to treat or not.” The risks include the negative effects of antibiotics, treatment failure, and reinfection as well as the possibility of losing the “protective effect” of H. pylori on atopy, allergy, and possibly on other gastrointestinal diseases. On the other hand, there are also many benefits of eradication therapy such as prevention of gastric complication and associated non-gastric complications as well as reduction of parental anxiety of nontreatment. This review summarizes the differences related to H. pylori in children versus adults and the risks and benefits of treatment in children.
Keywords: children, adults, treatment, Helicobacter pylori
Published in DiRROS: 14.01.2026; Views: 182; Downloads: 111
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3.
Adult congenital heart disease training in Europe : current status, disparities and potential solutions
Colin J McMahon, Inga Voges, Petra Jenkins, Margarita Brida, Annemien E Van der Bosch, Mikael Dellborg, Ruth Heying, Katja Prokšelj, 2023, original scientific article

Abstract: Objectives: This study aimed to determine the status of training of adult congenital heart disease (ACHD) cardiologists in Europe. Methods: A questionnaire was sent to ACHD cardiologists from 34 European countries. Results: Representatives from 31 of 34 countries (91%) responded. ACHD cardiology was recognised by the respective ministry of Health in two countries (7%) as a subspecialty. Two countries (7%) have formally recognised ACHD training programmes, 15 (48%) have informal (neither accredited nor certified) training and 14 (45%) have very limited or no programme. Twenty-five countries (81%) described training ACHD doctors ‘on the job’. The median number of ACHD centres per country was 4 (range 0–28), median number of ACHD surgical centres was 3 (0–26) and the median number of ACHD training centres was 2 (range 0–28). An established exit examination in ACHD was conducted in only one country (3%) and formal certification provided by two countries (7%). ACHD cardiologist number versus gross domestic product Pearson correlation coefficient=0.789 (p<0.001). Conclusion: Formal or accredited training in ACHD is rare among European countries. Many countries have very limited or no training and resort to ‘train people on the job’. Few countries provide either an exit examination or certification. Efforts to harmonise training and establish standards in exit examination and certification may improve training and consequently promote the alignment of high-quality patient care.
Keywords: congenital heart disease, adults, training, Europe
Published in DiRROS: 05.01.2026; Views: 312; Downloads: 94
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4.
Exercise-induced hypertension after aortic coarctation repair : our experience and a systematic review
Polona Kačar, Nejc Pavšič, Katja Prokšelj, 2024, original scientific article

Abstract: Background: The exact prevalence and clinical significance of excessive increase in blood pressure in response to exercise in patients with repaired coarctation of aorta (CoA) remains unknown.Aim: This study aimed to investigate the impact of different definitions of exercise-induced hypertension (EIH) on the prevalence rates in our adult patients with repaired CoA. A systematic review of the available literature was also performed.Methods: We retrospectively analyzed exercise test data from adult patients with repaired CoA followed at the national referral center for adult congenital heart disease between 1998 and 2021. The three most reported definitions of EIH in patients with repaired CoA were used for the analysis of EIH prevalence. We also performed a systematic search of the PubMed electronic bibliographic database. Full-text versions of all potentially relevant articles on EIH in CoA were reviewed for relevance.Results: Our registry included 161 adult CoA patients. Complete exercise test results were available in 74 patients (59% male, median age 39 years [range 20–68 years]). The prevalence of EIH in our cohort varied from 24 to 41%, depending on the definition used. We identified eleven eligible articles from 184 publications. The reported prevalence rate of EIH in the studies ranged from 13% to 82%.Conclusion: EIH is common in patients with repaired CoA; however, the rates of EIH vary greatly depending on the definition used. A standardized and uniform EIH definition is needed to accurately assess the prevalence and clinical relevance of EIH in this population.
Keywords: congenital heart disease, adults, aortic coarctation, exercise, hypertension
Published in DiRROS: 16.12.2025; Views: 400; Downloads: 100
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5.
Quality of life in adults with congenital heart disease : insights from a tertiary centre
Polona Kačar, Melita Flander, Katja Prokšelj, 2025, original scientific article

Abstract: Objective: As the survival of individuals born with congenital heart disease (CHD) improves into adulthood, the focus has shifted from traditional clinical outcomes to patient-reported outcome measures that better reflect the impact of the disease on daily life. Our aim was to assess the quality of life (QoL) of adult patients with congenital heart disease (ACHD) followed in a tertiary centre and to evaluate the parameters that influence QoL in this population. Methods: This cross-sectional observational study included patients followed up at the national referral ACHD centre between April and September 2022. Sociodemographic and clinical data were collected from medical records and self-report questionnaires. Quality of life (QoL) was assessed using the validated Short Form–36 (SF-36) and Euro Quality of Life–5 Dimension (EQ-5D) questionnaires, including the EQ Visual Analogue Scale (VAS). Results: A total of 123 ACHD patients were included (median age 34 (29–41) years; 43.9% male). Most participants had moderate CHD (61%), and 14.6% were cyanotic. Overall, SF-36 Physical Component Summary scores were higher than Mental Component Summary scores. Almost half of the patients (48.8%) reported no problems in all five domains of the EQ-5D, with most problems reported in anxiety/depression domain. Patients with severe CHD, cyanosis, or HF reported lower QoL scores across multiple SF-36 domains, particularly general health, role–physical, and physical functioning domains. Conclusions: QoL among ACHD patients in our cohort was generally high in most domains as assessed by the SF-36 and EQ-5D. Patients with HF reported lower QoL scores, emphasizing the importance of close clinical follow-up and the need for tailored QoL assessment tools for this complex population.
Keywords: adults, congenital heart disease, quality of life
Published in DiRROS: 16.12.2025; Views: 418; Downloads: 111
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Exhausted natural killer cells in adult IgA vasculitis
Matija Bajželj, Emanuela Senjor, Nika Boštic, Matjaž Hladnik, Snežna Sodin-Šemrl, Milica Perišić, Janko Kos, Alojz Ihan, Alojzija Hočevar, Andreja Nataša Kopitar, Katja Lakota, 2025, original scientific article

Abstract: Introduction. IgA vasculitis nephritis (IgAVN) manifests in up to 84% of adult patients with IgA vasculitis (IgAV) and is associated with an elevated risk of progression to chronic kidney failure. The underlying pathogenic mechanism of adult IgAVN in leukocytes remain largely uncharacterised. Although natural killer (NK) cells were investigated in paediatric IgAV, their specific role in the pathogenesis of adult IgAV has yet to be elucidated. Methods. RNA sequencing of leukocytes from adult IgAV patients and healthy controls (HC) was performed. NK cells’ cytotoxicity was assessed using calcein-AM stained K562 cells, and exocytosis was measured by LAMP-1/CD107a expression. Intracellular perforin and granzyme B were analyzed via flow cytometry, and cytokine secretion was measured by Luminex xMAP. Interferon-induced genes were validated with qPCR. Results. Principal component analysis (PCA) of leukocyte gene expression profiles distinguished IgAV patients from HC. Pathway enrichment analysis showed differences in patients’ subsets - Interferon signalling Reactome pathway was observed only in sample from patients with skin-limited IgAV (sl-IgAV) and was confirmed by increased expression of interferon-induced genes using qPCR. Only in samples from IgAVN patients enrichment of NK cell-mediated cytotoxicity KEGG pathway was found. NK cells from IgAVN patients showed significantly decreased cytotoxicity compared to samples from sl-IgAV patients (p = 2.53 × 10− 2). The % of CD107a+-NK cells significantly increased after stimulation in HC (p = 9.7 × 10− 3) and in sl-IgAV patient samples (p = 2.21 × 10− 2) while only a minor increase was observed in samples of IgAVN patients. IgAVN patients exhibited a decreased % of perforin+ NK cells compared to HC. Following phytohemagglutinin (PHA)/interleukin (IL)-2 stimulation, a significant reduction in intracellular perforin level was observed in HC (p = 2.53 × 10− 2), but not in IgAVN patients NK cells. Interferon (IFN)-ϒ and macrophage inflammatory protein (MIP)-1β were significantly decreased in NK cell culture supernatants from IgAVN patients (p = 2.64 × 10− 2 and p = 2.65 × 10− 2 respectively). Conclusion. Patients with IgAVN exhibited impaired cytotoxic and immunomodulatory functions of NK cells, along with a marked absence of interferon signaling in PBMCs. Further studies are needed to confirm if discrimination of patient subsets based on leukocyte samples might be of clinical use and if deregulated NK function might contribute to the pathogenesis of nephritis in adult IgAV.
Keywords: immunoglobulin A, IgAVN, IgA vasculitis, RNA sequencing, kidney diseases, immunoglobulins, killer cells, adults
Published in DiRROS: 12.11.2025; Views: 332; Downloads: 148
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