Iskanje po repozitoriju

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Povzetek: Purpose: Retained products of conception (RPOC) are a common complication following pregnancy. Office hysteroscopy (OH) is increasingly used for diagnostics and management due to its minimally invasive nature. However, incidence of incomplete OH removal and procedures in which no RPOC are identified despite prior suspicion remains a concern. This study aimed to identify factors associated with these outcomes to improve patient selection and procedural success. Methods: A retrospective study was conducted on patients referred for OH for presumed RPOC between August 2015 and April 2023 at the Department of Gynecology and Obstetrics, University Medical Centre Ljubljana, Slovenia. Inclusion criteria included hemodynamically stable patients with prolonged bleeding and/or suspicious ultrasound (US) findings post-pregnancy. Patients with RPOC thickness of more than 30 mm or strong tissue vascularization on US were excluded. Data on patient demographics, US features, and procedural outcomes were analyzed. Results: Out of the 468 patients, RPOC removal was performed in 333 cases (71.2%), of which 225 (67.6%) were successfully completed, while in 135 cases (28.8%), the procedure was only diagnostic due to the absence of RPOC. Regarding procedural success, neither the pregnancy outcome, i.e., termination of pregnancy (TOP) vs delivery, nor gestational age significantly correlated with it. Longer time from pregnancy end to OH significantly improved procedural success in both groups, after TOP (p = 0.025) and in cases of large RPOC after delivery (p < 0.001). Parity significantly altered procedural success only in the delivery group (p < 0.007). The success rate of the procedure was significantly higher in cases when only small RPOC were observed (p < 0.001). Absence of RPOC occurred more frequently following TOP than after delivery (p < 0.001). Procedures in which no RPOC were confirmed were significantly associated with a longer interval between pregnancy end and OH in both TOP (p = 0.013) and delivery group (p = 0.003). Gestational age significantly correlated with the absence of RPOC only in the delivery group (p = 0.003). The likelihood of not confirming RPOC was higher where US thickness and length were lower (p = 0.007 and p = 0.011, respectively). Conclusion: OH is effective for managing RPOC with a high success rate, but the absence of RPOC in a considerable number of OH-treated patients stresses the need for better diagnostic criteria and patient selection to minimize overtreatments. Further prospective studies are needed to optimize the timing and indications for OH.
Ključne besede: minimally invasive surgery, office hysteroscopy, retained products of conception, uterine diseases
Objavljeno v DiRROS: 09.04.2026; Ogledov: 105; Prenosov: 49
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Povzetek: This study explores the properties of supplementary cementitious materials (SCMs) obtained from the under-calcining thermal reactivation of construction and demolition waste fines (CDW) and of pure hydrated cement pastes (HCPs) derived from different commercial cements (CEM I, CEM II, CEM III, and CEM IV, classified according to EN 197–1). Samples were thermally treated at 350 ◦C (low-energy activation) and 600 ◦C (high-reactivity optimization) to increase pozzolanic and/or hydraulic behavior without inducing CO₂ release from calcination. Phase transformations were analyzed by X-ray Powder Diffraction with Rietveld refinement, thermal behavior by TGA/DTA, and morphological evolution by SEM, while reactivity and hydration kinetics were assessed using isothermal calorimetry. Results indicate pronounced differences in thermal response among the HCPs and CDW, governed by their specific phase assemblages and initial SCM content (limestone, slag, and pozzolans). At the selected under-calcining high-reactivity temperature (600 ◦C), γ-C₂S formation is favored. Thermal reactivation of slag-rich cement (CEM III) yielded the most reactive circular SCM, combining both high hydraulic (260 J/g - EN 196–11) and pozzolanic (329 J/g - ASTM C1897–20) performances with reduced carbon impacts.
Ključne besede: secondary scms, thermal reactivation, hydrated cement, clinker minerals
Objavljeno v DiRROS: 09.04.2026; Ogledov: 90; Prenosov: 65
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Povzetek: Background and aim: Diabetes has been shown in last decades to be associated with a significantly higher mortality among patients with ST-segment elevation myocardial infarction (STEMI) treated with primary PCI (PPCI). Therefore, the aim of current study was to evaluate the impact of diabetes on times delays, reperfusion and mortality in a contemporary STEMI population undergoing PPCI, including treatment during the COVID pandemic. Methods and results: The ISACS-STEMI COVID-19 is a large-scale retrospective multicenter registry involving PPCI centers from Europe, Latin America, South-East Asia and North-Africa, including patients treated from 1st of March until June 30, 2019 and 2020. Primary study endpoint of this analysis was in-hospital mortality. Secondary endpoints were postprocedural TIMI 0-2 flow and 30-day mortality. Our population is represented by 16083 STEMI patients. A total of 3812 (23,7 %) patients suffered from diabetes. They were older, more often males as compared to non-diabetes. Diabetic patients were less often active smokers and had less often a positive family history of CAD, but they were more often affected by hypertension and hypercholesterolemia, with higher prevalence of previous STEMI and previous CABG. Diabetic patients had longer ischemia time, had more often anterior MI, cardiogenic shock, rescue PCI and multivessel disease. They had less often out-of-hospital cardiac arrest and in-stent thrombosis, received more often a mechanical support, received less often a coronary stent and DES. Diabetes was associated with a significantly impaired postprocedural TIMI flow (TIMI 0-2: 9.8 % vs 7.2 %, adjusted OR [95 % CI] = 1.17 [1.02-1.38], p = 0.024) and higher mortality (in-hospital: 9.1 % vs 4.8 %, Adjusted OR [95 % CI] = 1.70 [1.43-2.02], p < 0.001; 30-day mortality: 10.8 % vs 6 %, Adjusted HR [95 % CI] = 1.46 [1.26-1.68], p < 0.001) as compared to non-diabetes, particularly during the pandemic. Conclusions: Our study showed that in a contemporary STEMI population undergoing PPCI, diabetes is significantly associated with impaired epicardial reperfusion that translates into higher in-hospital and 30-day mortality, particularly during the pandemic.
Ključne besede: STEMI, diabetes, reperfusion
Objavljeno v DiRROS: 31.03.2026; Ogledov: 180; Prenosov: 108
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Povzetek: The so-called “smoking paradox”, conditioning lower mortality in smokers among STEMI patients, has seldom been addressed in the settings of modern primary PCI protocols. The ISACS–STEMI COVID-19 is a large-scale retrospective multicenter registry addressing in-hospital mortality, reperfusion, and 30-day mortality among primary PCI patients in the era of the COVID-19 pandemic. Among the 16,083 STEMI patients, 6819 (42.3%) patients were active smokers, 2099 (13.1%) previous smokers, and 7165 (44.6%) non-smokers. Despite the impaired preprocedural recanalization (p < 0.001), active smokers had a significantly better postprocedural TIMI flow compared with non-smokers (p < 0.001); this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. Active smokers had a significantly lower in-hospital (p < 0.001) and 30-day (p < 0.001) mortality compared with non-smokers and previous smokers; this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. In conclusion, in our population, active smoking was significantly associated with improved epicardial recanalization and lower in-hospital and 30-day mortality compared with previous and non-smoking history.
Ključne besede: myocardial infarction, smoking paradox, percutaneous coronary intervention, COVID-19, mortality
Objavljeno v DiRROS: 31.03.2026; Ogledov: 150; Prenosov: 52
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Povzetek: Background: Chronic obstructive pulmonary disease (COPD) is projected to become the third cause of mortality worldwide. COPD shares several pathophysiological mechanisms with cardiovascular disease, especially atherosclero‑ sis. However, no definite answers are available on the prognostic role of COPD in the setting of ST elevation myocar‑ dial infarction (STEMI), especially during COVID-19 pandemic, among patients undergoing primary angioplasty, that is therefore the aim of the current study. Methods: In the ISACS-STEMI COVID-19 registry we included retrospectively patients with STEMI treated with pri‑ mary percutaneous coronary intervention (PCI) between March and June of 2019 and 2020 from 109 high-volume primary PCI centers in 4 continents. Results: A total of 15,686 patients were included in this analysis. Of them, 810 (5.2%) subjects had a COPD diagnosis. They were more often elderly and with a more pronounced cardiovascular risk profile. No preminent procedural dis‑ similarities were noticed except for a lower proportion of dual antiplatelet therapy at discharge among COPD patients (98.9% vs. 98.1%, P=0.038). With regards to short-term fatal outcomes, both in-hospital and 30-days mortality occurred more frequently among COPD patients, similarly in pre-COVID-19 and COVID-19 era. However, after adjust‑ ment for main baseline differences, COPD did not result as independent predictor for in-hospital death (adjusted OR [95% CI]=0.913[0.658–1.266], P=0.585) nor for 30-days mortality (adjusted OR [95% CI]=0.850 [0.620–1.164], P=0.310). No significant differences were detected in terms of SARS-CoV-2 positivity between the two groups. Conclusion: This is one of the largest studies investigating characteristics and outcome of COPD patients with STEMI undergoing primary angioplasty, especially during COVID pandemic. COPD was associated with significantly higher rates of in-hospital and 30-days mortality. However, this association disappeared after adjustment for baseline charac‑ teristics. Furthermore, COPD did not significantly affect SARS-CoV-2 positivity.
Ključne besede: COPD, STEMI, COVID-19
Objavljeno v DiRROS: 24.03.2026; Ogledov: 196; Prenosov: 102
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