1. Long-term outcome of multilayer flow modulator in aortic aneurysmsKarlo Pintarić, Lučka Boltežar, Nejc Umek, Dimitrij Kuhelj, 2024, original scientific article Abstract: ckground. This retrospective study investigated the efficacy of endovascular treatment with multilayer flow modu-lators (MFMs) for treating aortic aneurysms in high-risk patients unsuitable for conventional treatments.Patients and methods. Conducted from 2011 to 2019 at a single center, this retrospective observational study in-cluded 17 patients who underwent endovascular treatment with MFMs. These patients were selected based on theirunsuitability for traditional surgical or endovascular procedures. The study involved meticulous pre-procedural plan-ning, precise implantation of MFMs, and follow-up using CT angiography. The primary focus was on volumetric andflow volume changes in aneurysms, along with traditional diameter measurements. Moreover, the technical successand post-procedural complications were also registered.Results. The technical success rate was 100%, and 30-day procedural complication rate was 17.6%. Post-treatmentassessments revealed that 11 out of 17 patients showed a decrease in flow volume within the aneurysm sac, indicativeof a favorable hemodynamic response. The median decrease in flow volume was 12 ml, with a median relative de-crease of 8%. However, there was no consistent reduction in aneurysm size; most aneurysms demonstrated a medianincrease in volume for 46 ml and median increase in diameter for 18 mm.Conclusions. While MFMs offer a potential alternative for high-risk aortic aneurysm patients, their effectiveness in pre-venting aneurysm expansion is limited. The results suggest that MFMs can provide a stable hemodynamic environmentbut do not reliably reduce aneurysm size. This underscores the need for ongoing vigilance and long-term monitoringin patients treated with this technology
Keywords: multilayer flow modulator, aortic aneurism, long-term follow up, volumetric measurements
Published in DiRROS: 26.06.2026; Views: 149; Downloads: 117
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2. Long-term follow-up of 109 children with juvenile idiopathic oligoarthritis after first intra-articular corticosteroid injectionMojca Zajc Avramovič, Nataša Toplak, Gašper Markelj, Nina Emeršič, Tadej Avčin, 2024, original scientific article Abstract: Background: To evaluate long-term outcomes and prognostic factors in patients with juvenile idiopathic arthritis (JIA), presenting as oligoarthritis, who received IAC as the first treatment for their disease. Methods: We conducted retrospective study at the University Children's Hospital Ljubljana, Slovenia, from January 2015 to May 2023 in children with JIA, clinically presenting as oligoarthritis receiving intra-articular corticosteroid injection (IAC) as the initial treatment. Patient and treatment data were collected, and the outcomes were categorized into three groups based on the later need for therapy: no therapy needed, only additional IAC needed and systemic therapy needed. The last group was further divided based on the requirement of bDMARD. Log-rank (Mantel-Cox) survival analyses compared different outcome groups. Results: We included 109 patients with JIA, presenting as oligoarthritis (63% female), who were first treated with IAC. The mean age at IAC was 8.0 years, with a 4.3-year follow-up. Notably, 38.5% of patients did not require additional therapy post-IAC, whereas 15.5% required only additional IAC. Systemic therapy, mainly methotrexate (MTX), was necessary for 45.9% of patients, initiated in average 7.8 months post-IAC. Biologic therapy was initiated in 22% in average 2.2 years post-IAC. Number of injected joints correlated with the need for biologics. At the last follow-up, 88.9% had inactive disease. ANA positivity (P = 0.049, chi square 3.89) and HLA B27 antigen presence (P = 0.050, chi square 3.85) were associated with the need for systemic therapy. A subgroup of children older than 8 years, ANA and HLA B27 negative required significantly less systemic (25.8%) and biologic therapy (9.6%) compared to other patients (p = 0.050, chi square 3.77). Conclusion: Almost 40% of children with oligoarticular JIA requiring IAC did not progress to chronic disease. Younger age, ANA positivity, and HLA B27 presence were predictive factors for systemic therapy, while the number of injected joints predicted the future need for biologic therapy
Keywords: ANA, biologic therapy, HLA B27, juvenile idiopathic arthitis, long-term follow-up, methotrexate, oligoarthritis, outcome, pediatric arthritis
Published in DiRROS: 04.06.2026; Views: 271; Downloads: 161
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3. The impact of follow-up on etiological classification of pediatric vertigoNina Božanić Urbančič, Dejan Mladenov, Saba Battelino, 2026, original scientific article Abstract: Background: Vertigo and dizziness in children represent diagnostically challenging conditions with heterogeneous etiologies. At initial presentation, a substantial proportion of pediatric patients remain without a definitive etiological diagnosis. Evidence on the impact of longitudinal follow-up on etiological classification in pediatric vertigo is limited. Methods: This observational cohort study uses prospectively collected clinical data. Children aged 1-17 years who presented to a tertiary ENT clinic with vertigo and/or dizziness between 2015 and 2020 were systematically enrolled and followed. The present study represents a retrospective revision of a previously published cohort of 257 children. In 2025, extended follow-up data were reviewed to reassess etiological classification using the same diagnostic categories as in the original analysis. Descriptive statistics were applied to compare etiological distributions at initial evaluation and after follow-up revision. Results: After data revision, the proportion of children with unclassified etiology decreased from 44% to 10%. Central etiologies accounted for 35% of cases, peripheral vestibular disorders for 18%, hemodynamic causes for 16%, psychogenic etiologies for 10%, and other specific causes for 7%. Follow-up duration ranged from 0 to 132 months (mean 17.6 months; median 4.5 months). Diagnostic investigations were frequently performed; however, the etiological yield of certain tests, particularly cranial computed tomography, was low. Conclusions: Extended follow-up significantly improves etiological classification in children with vertigo and dizziness, demonstrating that diagnostic uncertainty at initial presentation often reflects evolving clinical phenotypes rather than the absence of an underlying disorder. A longitudinal, clinically guided, and multidisciplinary approach is essential to enhance diagnostic accuracy and optimize the use of diagnostic investigations in pediatric vertigo.
Keywords: dizziness, etiology, follow-up, migraine, pediatric vertigo, vestibular disorders
Published in DiRROS: 15.05.2026; Views: 169; Downloads: 143
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4. Long-term outcome of the retropubic TVT procedure for women with stress urinary incontinence : 20–25-year follow-upVojka Lebar, Adolf Lukanovič, Miha Matjašič, Matija Barbič, David Lukanović, 2025, original scientific article Abstract: Introduction Stress urinary incontinence (SUI) significantly affects women’s quality of life. The tension-free vaginal tape (TVT) procedure has demonstrated short- and medium-term efficacy, but data beyond 15 years remain scarce. This study evaluates the 20- to 25-year outcomes of the retropubic TVT procedure in terms of efficacy, safety, and patient satisfaction. Methods This retrospective cohort study included 135 women that underwent the retropubic TVT procedure between 1998 and 2003. All surgeries were performed by two surgeons using the Gynecare TVT™ Sling. Data were obtained from medical records, follow-ups, and telephone interviews (January–March 2024). Outcomes were assessed using the Patient Global Impression of Improvement (PGI-I), International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF), and Urinary Distress Inventory–Short Form (UDI-6). Results Out of 593 women originally treated, 135 completed long-term follow-up. The mean age at surgery was 50.3 years and 72.5 years at follow-up. The median PGI-I score of 2.0 indicated that 76.3 % of patients reported significant improvement. The median ICIQ-SF score was 7.0, reflecting moderate symptom burden, and the median UDI-6 score was 22.2, with 20 % of patients reporting significant urgency symptoms. Postoperative complications were low; 85.9 % of patients had no complications, 13.3 % experienced urinary retention, and 0.7 % had tape erosion. Repeat TVT was required in 9.6 % of cases, with significantly lower satisfaction (p = 0.002). PGI-I scores strongly correlated with ICIQ-SF (r = 0.801, p < 0.01) and UDI-6 (r = 0.676, p < 0.01). Conclusions TVT remains an effective long-term SUI treatment with high satisfaction and low complications. Long-term follow-up is essential for monitoring late-onset complications.
Keywords: urinary incontinence, stress urinary incontinence, surgery, TVT, follow-up
Published in DiRROS: 09.03.2026; Views: 377; Downloads: 321
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5. European society of clinical microbiology and infectious diseases guidelines for antimicrobial stewardship in emergency departments (endorsed by European association of hospital pharmacists)Teske Schoffelen, Cihan Papan, Elena Carrara, Khalid Eljaaly, Paul Mical, Emma Keuleyan, Alejandro Martin Quirós, Nathan Peiffer-Smadja, Bojana Beović, 2024, review article Abstract: Scope: This European Society of Clinical Microbiology and Infectious Diseases guideline provides evidence-based recommendations to support a selection of appropriate antibiotic use practices for patients seen in the emergency department (ED) and guidance for their implementation. The topics addressed in this guideline are (a) Do biomarkers or rapid pathogen tests improve antibiotic prescribing and/or clinical outcomes? (b) Does taking blood cultures in common infectious syndromes improve antibiotic prescribing and/or clinical outcomes? (c) Does watchful waiting without antibacterial therapy or with delayed antibiotic prescribing reduce antibiotic prescribing without worsening clinical outcomes in patients with specific infectious syndromes? (d) Do structured culture follow-up programs in patients discharged from the ED with cultures pending improve antibiotic prescribing? Methods: An expert panel was convened by European Society of Clinical Microbiology and Infectious Diseases and the guideline chair. The panel selected in consensus the four most relevant antimicrobial stewardship topics according to pre-defined relevance criteria. For each main question for the four topics, a systematic review was performed, including randomized controlled trials and observational studies. Both clinical outcomes and stewardship process outcomes related to antibiotic use were deemed relevant. The literature searches were conducted between May 2021 and March 2022. In April 2022, the panel members were formally asked to suggest additional studies that were not identified in the initial searches. Data were summarized in a meta-analysis if possible or otherwise summarized narratively. The certainty of the evidence was classified according to the Grading of Recommendations Assessment, Development and Evaluation criteria. The guideline panel reviewed the evidence per topic critically appraising the evidence and formulated recommendations through a consensus-based process. The strength of the recommendations was classified as strong or weak. To substantiate the implementation process, implementation trials or observational studies describing facilitators/barriers for implementation were identified from the same searches and were summarized narratively. Recommendations: The recommendations on the use of biomarkers and rapid pathogen diagnostic tests focus on the initiation of antibiotics in patients admitted through the ED. Their effect on the discontinuation or de-escalation of antibiotics during hospital stay was not reported, neither was their effect on hospital infection prevention and control practices. The recommendations on watchful waiting (i.e. withholding antibiotics with some form of follow-up) focus on specific infectious syndromes for which the primary care literature was also included. The recommendations on blood cultures focus on the indication in three common infectious syndromes in the ED explicitly excluding patients with sepsis or septic shock. Most recommendations are based on very low and low certainty of evidence, leading to weak recommendations or, when no evidence was available, to best practice statements. Implementation of these recommendations needs to be adapted to the specific settings and circumstances of the ED. The scarcity of high-quality studies in the area of antimicrobial stewardship in the ED highlights the need for future research in this field.
Keywords: antimicrobial stewardship, blood cultures, culture follow-up, diagnostic tests, emergency department, guideline, implementation, rapid tests, recommendations, watchful waiting
Published in DiRROS: 09.03.2026; Views: 520; Downloads: 613
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6. Circulating miRNAs correlate with clinical evaluation of activity in ANCA-associated glomerulonephritisMatic Bošnjak, Željka Večerić-Haler, Živa Pipan Tkalec, Emanuela Boštjančič, Nika Kojc, 2025, original scientific article Abstract: Introduction: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is an autoimmune necrotizing small vessel vasculitis, frequently resulting in severe renal manifestations such as rapidly progressive glomerulonephritis (AAV-GN). Monitoring disease activity and determining ongoing renal involvement remain significant clinical challenges due to the limitations associated with traditional biomarkers. This study focused on the potential of circulating microRNA (miRNA) as supplementary noninvasive biomarkers for disease activity in AAV-GN. Methods: This prospective follow-up study involved serum samples from 60 patients with biopsy-proven AAV-GN, collected at renal biopsy and at 3-, 6-, 12-, and 24-month intervals post-biopsy. Nine miRNAs (miR-21-3p, miR-30b/d/e-5p, miR-142-5p, miR-150-5p, miR-181a-5p, miR-181b-5p, and let-7a-5p) were selected based on the differential expressions in renal tissue and corresponding serum samples identified in the previous research phases. Expression analysis was performed using quantitative real-time polymerase chain reaction and correlated with disease activity based on the Birmingham Vasculitis Activity Score and other clinical parameters. Results: A significant correlation was identified between disease activity and the expression levels of the miR-30 family members and let-7a. Specifically, these miRNAs demonstrated consistent correlation patterns across follow-up samples independent of the time elapsed post-biopsy, with down-regulation correlating with the presence of active disease. Notably, the miRNA expression profile in partial remission appeared analogous to that of complete remission, suggesting that many patients categorized as having partial remission may, in fact, be considered in true clinical remission. Conclusion: This study supports serum miRNA profiling as an adjunct noninvasive biomarker for assessing disease activity in AAV-GN. Such an approach could provide complementary information alongside traditional biomarkers and refine the future management of AAV-GN. However, it is important to acknowledge that our actual study cohort was small due to challenging technical aspects of miRNA expression analysis in the serum. Therefore, further research with larger cohorts is required to validate these results and assess their clinical applicability.
Keywords: ANCA, vasculitis, glomerulonephritis, microRNA, biomarker, BVAS, epigenetics, follow-up
Published in DiRROS: 26.11.2025; Views: 555; Downloads: 349
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7. Cellular and humoral response after induction of protection and after finishing Hymenoptera venom immunotherapyAjda Demšar Luzar, Matija Rijavec, Mitja Košnik, Urška Bidovec, Jerneja Debeljak, Mihaela Zidarn, Peter Kopač, Peter Korošec, 2024, original scientific article Keywords: Hymenoptera venom immunotherapy, sting challenge, biomarkers, serology, basophil activation test, follow-up
Published in DiRROS: 19.02.2025; Views: 1134; Downloads: 812
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