1. Risk factors for severe sting reactions and side effects during venom immunotherapyGunter Sturm, Eva Schadelbauer, Giorgia Marta, Patrizia Bonadonna, Mitja Košnik, 2025, review article Abstract: Understanding the risk factors leading to severe systemic sting reactions (SSRs) is crucial for initiating venom immunotherapy (VIT) and for educating affected individuals and their families. Some of these risk factors are well established, some are no longer considered risk factors, and some remain controversial. Well-established risk factors for severe SSRs include clonal mast cell disease, high baseline serum tryptase, and advanced age. The absence of skin symptoms and the rapid onset of symptoms are indicators of severe SSRs. Recent publications indicate that antihypertensive treatment and stings in the head and neck area are not risk factors for severe SSRs. VIT is the only available treatment that can potentially prevent further anaphylactic reactions. Although rare and generally manageable, individuals undergoing VIT may experience systemic adverse events (sAEs). More sAEs are expected in patients undergoing bee VIT compared with vespid VIT. The role of elevated baseline serum tryptase as a risk factor for sAEs remains debated, but if it is a factor, the risk is increased by only about 1.5-fold. Rapid updosing protocols, depending on the specific regimen, can also be associated with more sAEs. Severe initial SSRs, antihypertensive medication, high skin test reactivity, and high specific IgE levels are not risk factors for sAEs. Keywords: immunology, anaphylaxis, Hymenoptera venom allergy, risk factors, severe systemic sting reactions, side effects, venom immunotherapy Published in DiRROS: 02.07.2025; Views: 126; Downloads: 74
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2. Risk of anaphylaxis associated with cold urticariaMojca Bizjak, Krzysztof Rutkowski, Ricardo Assero, 2024, review article Abstract: Purpose of review
Cold-induced anaphylaxis (ColdA) is a poorly understood form of anaphylaxis that occurs in patients with cold urticaria (ColdU). This comprehensive review aims to deepen the understanding of ColdA. It emphasizes the identification of high-risk ColdU patients susceptible to ColdA and provides recommendations for their effective management.
Recent findings
Recent studies, including the large international COLD-CE study, have identified clinical features of ColdU patients associated with increased ColdA risk. These individuals can now be recognized through routine clinical assessments. Key diagnostic indicators for assessing ColdU and the risk of ColdA include oropharyngeal/laryngeal symptoms and positive standard local cold provocation tests. ColdA has been defined as acute cold-induced involvement of the skin and/or visible mucosal tissue accompanied by cardiovascular manifestations, difficulty breathing, or gastrointestinal symptoms, but a universally accepted definition is lacking. Additionally, ColdA has recently been recognized as an indication for prescribing adrenaline (epinephrine) autoinjectors, marking a significant advancement in disease management.
Summary
ColdA is a major and potentially life-threatening concern for a subset of ColdU patients. Early recognition of high-risk patients, coupled with education and preparedness of both patients and healthcare providers, is crucial for effectively managing this challenging condition. Further research is needed to expand understanding of the underlying pathophysiological mechanisms of ColdA, identify potential cofactors influencing ColdA, and improve disease-management strategies. Keywords: adrenaline (epinephrine), autoinjector, cold-induced anaphylaxis, cold urticaria, management, risk factors Published in DiRROS: 28.05.2025; Views: 191; Downloads: 104
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3. Prevalence of sarcopenia among Slovenian older adults and associated risk factorsKatarina Puš, Saša Pišot, Uroš Marušič, Manca Peskar, Kaja Teraž, Miloš Kalc, Helena Blažun Vošner, Peter Kokol, Jernej Završnik, Boštjan Šimunič, 2025, original scientific article Abstract: Introduction: Sarcopenia is a multifaceted condition affecting between 10 and 16% of the global population, and although multiple classification algorithms exist, no prevalence has been reported for a representative sample of the Slovenian population. Furthermore, multiple behavioural factors, such as malnutrition, physical inactivity, sedentary lifestyle and lower cognitive function, can contribute to the risk of sarcopenia. This study aims to: a) determine sarcopenia prevalence among Slovenian older adults according to different classification algorithms, b) compare the agreement among the algorithms and c) evaluate the relationship between proposed risk factors and sarcopenia. Methods: 654 participants (≥60 years, 30.4% males) have been classified into sarcopenia groups according to eight algorithms, and agreement (Fleiss K) between them was calculated. Additionally, age, sex, nutritional status, physical activity, sedentary levels and cognitive function were assessed as sarcopenia risk/protective factors. Results: The prevalence of sarcopenia according to EWGSOP2 was 4.1%, ranging from 2.1% to 15.3%, when classified by all eight algorithms. Overall agreement between algorithms was weak (K=.429; 95% CI .414 to .444) with 0.6% of participants classified as sarcopenic by all eight algorithms. Adequate nutrition and physical activity were identified as protective factors, while age, lower cognitive function and sedentary lifestyle were considered risk factors. Conclusion: Sarcopenia prevalence among the Slovenian general population was lower than in the global population. We can conclude that different sarcopenia algorithms lead to a different prevalence of sarcopenia. It is of great importance to be cautious when comparing prevalences among studies and to further validate the classification algorithms. Keywords: sarcopenia, prevalence, epidemiology, classification algorithms, risk factors Published in DiRROS: 03.03.2025; Views: 307; Downloads: 151
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4. Breast cancer risk based on adapted IBIS prediction model in Slovenian women aged 40-49 years : coul it be better?Tjaša Oblak, Vesna Zadnik, Mateja Krajc, Katarina Lokar, Janez Žgajnar, 2020, original scientific article Keywords: breast surgery, IBIS, prediction models, risk factors Published in DiRROS: 12.07.2024; Views: 561; Downloads: 209
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5. Effects of governmental data governance on urban fire risk : a city-wide analysis in ChinaZhao-Ge Liu, Xiang-Yang Li, Grunde Jomaas, 2022, original scientific article Abstract: The effects of data governance (as a means to maximize big data value creation in fire risk management) performance on fire risk was analyzed based on multi-source statistical data of 105 cities in China from 2016 to 2018. Specifically, data governance was first quantified with ten detailed indicators, which were then selected for explaining urban fire risk through correlation analysis. Next, the sample cities were clustered in terms of major socio-economic characteristics, and then the effects of data governance were examined by constructing multivariate regression models for each city cluster with ordinary least squares (OLS). The results showed that the constructed regression models produced good interpretation of fire risk in different types of cities, with coefficient of determination (R2) in each model exceeding 0.65. Among the indicators, the development of infrastructures (e.g. data collection devices and data analysis platforms), the level of data use, and the updating of fire risk related data were proved to produce significant effects on the reduction of fire frequency and fire consequence. Moreover, the organizational maturity of data governance was proved to be helpful in reducing fire frequency. For the cities with large population, the cross-department sharing of high-value data was found to be another important determinant of urban fire frequency. In comparison with existing statistical models which interpreted fire risk with general social factors (with the highest R2 = 0.60), these new regression models presented a better statistical performance (with the average R2 = 0.72). These findings are expected to provide decision support for the local governments of China and other jurisdictions to facilitate big data projects in improving fire risk management. Keywords: urban fire risk, fire risk management, big data technologies, data governance, socio-economic factors, city-wide analysis Published in DiRROS: 09.01.2024; Views: 833; Downloads: 414
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6. Risk factors for systemic reactions in typical cold urticaria : results from the COLD-CE studyMojca Bizjak, Mitja Košnik, Dejan Dinevski, Simon Francis Thomsen, Daria Fomina, Elena Borzova, Kanokvalai Kulthanan, Raisa Meshkova, Dalia Melina Ahsan, Mona Al-Ahmad, Jovan Miljković, Dorothea Terhorst, Marcus Maurer, 2022, original scientific article Abstract: Background. Cold urticaria (ColdU), i.e. the occurrence of wheals or angioedema in response to cold exposure, is classified into typical and atypical forms. The diagnosis of typical ColdU relies on whealing in response to local cold stimulation testing (CST). It can also manifest with cold-induced anaphylaxis (ColdA). We aimed to determine risk factors for ColdA in typical ColdU. Methods. An international, cross-sectional study COLD-CE was carried out at 32 urticaria centers of reference and excellence (UCAREs). Detailed history was taken and CST with an ice cube and/or TempTest® performed. ColdA was defined as an acute cold-induced involvement of the skin and/or visible mucosal tissue and at least one of: cardiovascular manifestations, difficulty breathing, or gastrointestinal symptoms. Results. Of 551 ColdU patients, 75% (n=412) had a positive CST and ColdA occurred in 37% (n=151) of the latter. Cold-induced generalized wheals, angioedema, acral swelling, oropharyngeal/laryngeal symptoms, and itch of earlobes were identified as signs/symptoms of severe disease. ColdA was most commonly provoked by complete cold water immersion and ColdA caused by cold air was more common in countries with a warmer climate. Ten percent (n=40) of typical ColdU patients had a concomitant chronic spontaneous urticaria (CSU). They had a lower frequency of ColdA than those without CSU (4% vs 39%, p=0.003). We identified the following risk factors for cardiovascular manifestations: previous systemic reaction to a Hymenoptera sting, angioedema, oropharyngeal/laryngeal symptoms, and itchy earlobes. Conclusion. ColdA is common in typical ColdU. High-risk patients require education about their condition and how to use an adrenaline autoinjector. Keywords: urticaria, risk factors, epinephrine - therapeutic use, self administration, intramuscular injections - methods, cold urticaria, systemic reactions, adrenaline autoinjector Published in DiRROS: 31.08.2022; Views: 1295; Downloads: 501
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7. Natural history of the hymenoptera venom sensitivity reactions in adults : study designSimona Perčič, Lidija Bojanić, Mitja Košnik, Andreja Kukec, 2022, original scientific article Abstract: Background: Allergic reactions to Hymenoptera stings can have varying levels of severity,
according to the Müller grading system. Methods: By an epidemiological concept, this is a retrospective
cohort study. The observed cohort was represented by patients referred to the University Clinic
Golnik due to Hymenoptera allergic reaction in the period from 1997 to 2015. From the immunological
database of the University Clinic Golnik, we obtained laboratory data (sIgE, skin tests and basophil
activation test). The clinical characteristics of patients were obtained from BIRPIS. With the help of a
questionnaire, which was sent to each patient in the period from May 2019 to April 2021, we obtained
epidemiological data. For the assessment of the association between the severity of allergic reaction
for the observed outcome, the severity of the first allergic reaction after Hymenoptera sting was used.
Other variables were grouped according to risk factors. Discussion: We will identify the risk factors
that could play an important role in a severe systemic reaction: the aetiology of the Hymenoptera
sting, sex, age, history and severity of previous systemic reactions, being re-stung in an interval of
two months, the frequency of re-stings, atopy, genetic predisposition, preventive medication use,
other medication use, beekeeping or living next to beehives and why immunotherapy was not taken.
Laboratory data will also be analysed to determine if there is any association with laboratory tests and
the severity of the allergic reactions after Hymenoptera stings. Conclusions: Several new approaches
are introduced in the study design. The most important is that the protocol covers epidemiological
data gained from the questionnaire, as well as clinical data gained from the Immunological database
and BIRPIS database. We expect to obtain significant results that will explain the risk factors for the
natural history of Hymenoptera sting allergic reactions and will help allergologists, as well as general
doctors, when facing those patients allergic to Hymenoptera venom without immunotherapy. Keywords: hymenoptera venom allergy, risk factors, epidemiological association Published in DiRROS: 06.04.2022; Views: 1654; Downloads: 639
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8. Prevalence of and factors associated with healthcare-associated infections in Slovenian acute care hospitals : results of the third national surveyIrena Klavs, Mojca Serdt, Aleš Korošec, Tatjana Lejko-Zupanc, Blaž Pečavar, 2019, original scientific article Abstract: Introduction. In the third Slovenian national healthcare-associated infections (HAIs) prevalence survey, conducted within the European point prevalence survey of HAIs and antimicrobial use in acute care hospitals, we estimated the prevalence of all types of HAIs and identified factors associated with them. Methods. Patients were enrolled into a one-day cross-sectional study in November 2017. Descriptive analyses were performed to describe the characteristics of patients, their exposure to invasive procedures and the prevalence of different types of HAIs. Univariate and multivariate analyses of association of having at least one HAI with possible risk factors were performed to identify risk factors. Results. Among 5,743 patients, 4.4% had at least one HAI and an additional 2.2% were still treated for HAIs on the day of the survey, with a prevalence of HAIs of 6.6%. The prevalence of pneumoniae was the highest (1.8%), followed by surgical site infections (1.5%) and urinary tract infections (1.2%). Prevalence of blood stream infections was 0.3%. In intensive care units (ICUs), the prevalence of patients with at least one HAI was 30.6%. Factors associated with HAIs included central vascular catheter (adjusted odds ratio [aOR] 4.1; 95% confidence intervals [CI]: 3.1–5.4), peripheral vascular catheter (aOR 3.0; 95% CI: 2.3–3.9), urinary catheter (aOR 1.8; 95% CI: 1.4–2.3). Conclusions. The prevalence of HAIs in Slovenian acute care hospitals in 2017 was substantial, especially in ICUs. HAIs prevention and control is an important public health priority. National surveillance of HAIs in ICUs should be developed to support evidence-based prevention and control. Keywords: healthcare-associated infections, prevalence, survey, risk factors, Slovenia Published in DiRROS: 16.10.2020; Views: 3456; Downloads: 1357
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