1. Characteristics and predictors of clinical outcome in patients with pleural effusions caused by heart, liver and renal failure: results from the ERS International Multicentre Pleural Research Collaborative (IMPACT) registryHugh Welch, Steven Walker, Jordy Kerkhoff, Julius Janssen, Silvia Bielsa, C Civit, José M. Porcel, K Fjaellegaard, J Petersen, U Bodtger, Elzbieta Magdalena Grabczak, Mohamed Ellayeh, Aleš Rozman, Mateja Marc-Malovrh, Rahul Bhatnagar, 2025, izvirni znanstveni članek Povzetek: Introduction Pleural effusions caused by organ dysfunction are the commonest pleural disease and account for a huge healthcare burden. Previous work has demonstrated poor survival rates, but there is still uncertainty about determinants of prognosis. This study describes the characteristics and risk factors for poor outcomes in patients with pleural effusion secondary to organ failure in an international cohort. Methods The European Respiratory Society International Multicentre Pleural Research Collaborative (IMPACT) registry includes an international retrospective study of patients with effusions secondary to heart, liver or renal failure, collected from 10 countries in Europe and North and South America between 2019 and 2021. The data were analysed for associations between baseline patient characteristics and key clinical outcomes. Descriptive data were collected on treatments and complications. Results A total of 755 patients contributed data. Overall, 85.2% of effusions were classified as transudates by Light's criteria. 42% of effusions were bilateral. One-year mortality rates were 46% in renal, 35% in hepatic and 33% in cardiac effusions. Increased mortality was observed in neutrophil-predominant effusions (HR 2.001, 95% CI 1.202–3.349, p=0.008), with age (HR 1.013, 95 CI 1.002–1.024, p=0.02) and with N-terminal pro-brain natriuretic peptide >450 pg·mL−1 (HR 1.508, 95% CI 1.191–1.911) in patients with cardiac failure. Therapeutic thoracentesis was the most frequently employed pleural intervention; indwelling pleural catheter use was rare and associated with higher pleural infection rates than thoracentesis. Conclusion This study identifies prognostic factors in an international cohort of patients with transudative pleural effusions. Identification of these risk factors may support treatment approaches in a global population.
Objavljeno v DiRROS: 02.02.2026; Ogledov: 237; Prenosov: 187
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2. Errata : ocena kadrovskih potreb za izvajanje zdravljenja raka v Republiki SlovenijiKatarina Lokar, Marjana Bernot, Maja Ebert Moltara, Mateja Marc-Malovrh, Radivoje Pribaković Brinovec, Brigita Skela-Savič, Vesna Zadnik, Tina Žagar, Branko Zakotnik, 2021, drugi sestavni deli Ključne besede: načrtovanje zdravstvenega osebja, zdravljenje raka, paliativna oskrba, incidenca, umrljivost, napovedovanje
Objavljeno v DiRROS: 22.01.2026; Ogledov: 281; Prenosov: 175
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4. Cytokine profiles of bronchoalveolar lavage in patients with interstitial lung diseases and non-allergic asthmaDana Greif Lenarčič, Urška Bidovec, Pia Kristanc, Peter Kopač, Mateja Marc-Malovrh, Izidor Kern, Katarina Osolnik, 2025, izvirni znanstveni članek Povzetek: Diagnosing and prognosing immune-mediated airway diseases, like hypersensitivity pneumonitis (HP) and sarcoidosis, is complicated due to their overlapping symptoms and the lack of definitive biomarkers. Hence, we wanted to compare bronchoalveolar lavage (BAL) cytokine and chemokine profiles from 92 patients with different immune-mediated and inflammatory airway diseases, namely, HP, sarcoidosis, non-allergic asthma, amiodarone lung, and EGPA. We also compared pulmonary function parameters, BAL’s cellularity, and lymphocyte immunophenotypes. We found significant differences across all measured lung functions (VC, VC%, FEV1, FEV1%, and Tiff%) and in the number of macrophages, lymphocytes, neutrophils, and eosinophils. Furthermore, we showed significant differences in CD4, CD8, and CD4/8 across all included ILDs and OLDs; however, no significant differences were found in CD3, CD19, NK, or NKT. We identified nine biomarkers (IL-1β, IL-6, IL-8, IL-13, VEGF, angiogenin, C4a, RANTES, and MCP-1) that significantly differ in the BAL of patients with HP and sarcoidosis and showed that RANTES and IL-6 are associated with fibrotic outcome. We have demonstrated that interstitial and obstructive lung diseases differ in cytokine and cellular lung imprint, which may, in the future, enable the determination of the disease subtype and thus the identification of targets for the treatment of individuals or subgroups within diseases.
Ključne besede: hypersensitivity pneumonitis, sarcoidosis, non-allergic asthma, amiodarone lung, EGPA, cytokines, bronchoalveolar lavage, chemokines, complement anaphylatoxins, angiogenesis-related factors
Objavljeno v DiRROS: 05.08.2025; Ogledov: 700; Prenosov: 402
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5. Fibulin-3 in plasma and pleural effusion as a biomarker of mesotheliomaKatja Adamič, Mateja Marc-Malovrh, Urška Bidovec, Aleš Rozman, 2025, izvirni znanstveni članek Povzetek: Background: Malignant pleural mesothelioma (MPM) is a global health concern linked to asbestos exposure. In Slovenia, regions with high asbestos exposure rates make MPM a significant public health issue. Although thoracoscopic biopsy is the gold standard for MPM diagnosis, its invasiveness highlights the need for reliable, non-invasive diagnostic biomarkers. Patients and Methods: This prospective study evaluated the diagnostic potential of fibulin-3 as a biomarker for MPM, focusing on its ability to distinguish MPM from other pleural conditions, its association with disease stage and histological subtype, and its prognostic value for survival. 90 patients who underwent diagnostic thoracoscopic biopsy from January 2013 to October 2014 were included. Fibulin-3 levels in plasma and pleural effusion were measured using ELISA, and clinical data were analysed with statistical tests, including ROC analysis. Results: The study cohort comprised 32 patients with MPM, 24 with metastatic pleural carcinoma, and 34 with benign pleural diseases. Plasma fibulin-3 levels were significantly elevated (p = 0.0132) in MPM patients compared to those with benign pleural effusions due to asbestos exposure, with a cut-off of 12.31 ng/mL showing 100% specificity but low sensitivity (39.39%). Elevated fibulin-3 levels in pleural effusion correlated with advanced disease (p = 0.0463) and aggressive histological subtypes (p = 0.0324). No significant survival correlation was observed. Conclusions: While plasma fibulin-3 is a highly specific biomarker for MPM, its low sensitivity limits its standalone diagnostic utility. Its potential role in risk stratification and early detection in at-risk populations warrants further study.
Ključne besede: fibulin-3, asbestos, pleural effusion, mesothelioma, biomarker
Objavljeno v DiRROS: 18.06.2025; Ogledov: 661; Prenosov: 339
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6. Bronchial bacterial colonization and the susceptibility of isolated bacteria in patients with lung malignancyBojana Beović, Viktorija Tomič, Marko Bitenc, Mateja Marc-Malovrh, Vladimir Dimitrić, Dane Lužnik, Martina Miklavčič, Tamara Božič, Tina Gabrovec, Aleksander Sadikov, Aleš Rozman, 2025, izvirni znanstveni članek Povzetek: Background Postoperative pneumonia (POP) remains a leading cause of mortality following lung surgery. Recent studies have confirmed that the respiratory tract below the vocal cords is not sterile and often harbours potentially pathogenic microorganisms (PPMs), putting patients with lung malignancies at an increased risk for pulmonary infections. Patients and methods The study analysed 149 patients who underwent bronchoscopy for lung lesions suspected to be lung cancer. Protected specimen brush (PSB) samples were obtained during bronchoscopy prior to any specific treatment. Bacterial identification and antimicrobial susceptibility testing were conducted on the isolated strains. Results Bacterial colonization was detected in 88.6% of patients, with 21.5% carrying PPMs. Notably, patients with type 2 diabetes exhibited a higher rate of PPM colonization compared to others. Antibiotic susceptibility testing showed no significant differences in efficacy between amoxicillin with clavulanic acid and first-generation cephalosporin in both colonized patients and those with PPMs. Importantly, no multidrug-resistant bacteria were identified. Conclusions Our findings indicate a slightly lower PPM colonization rate compared to previous studies, possibly due to the unique geographic characteristics of the study population. The absence of significant differences in bacterial susceptibility between the two tested antibiotics highlights the need for further research to refine perioperative infection management strategies.
Ključne besede: bronchial bacterial colonization, potentially pathogenic microorganisms, antibiotic prophylaxis
Objavljeno v DiRROS: 03.06.2025; Ogledov: 726; Prenosov: 419
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7. Unravelling the lung cancer diagnostic pathway : identifying gaps and opportunities for improvementMateja Marc-Malovrh, Katja Adamič, 2024, izvirni znanstveni članek Povzetek: Background
A fast and well-organized complex diagnostic process is important for better success in the treatment of lung cancer patients. The aim of our study was to reveal the gaps and inefficiencies in the diagnostic process and to suggest improvement strategies in a single tertiary centre in Slovenia.
Patients and methods
We employed a comprehensive approach to carefully dissect all the steps in the diagnostic journey for individuals suspected of having lung cancer. We gathered and analysed information from employees and patients involved in the process by dedicated questionnaires. Further, we analysed the patients’ data and calculated the diagnostic intervals for patients in two different periods.
Results
The major concerns among employees were stress and excessive administrative work. The important result of the visual journey and staff reports was the design of electronic diagnostic clinical pathway (eDCP), which could substantially increase safety and efficacy by diminishing the administrative burden of the employees. The patients were generally highly satisfied with diagnostic journey, but reported too long waiting times. By analysing two time periods, we revealed that diagnostic intervals exceeded the recommended timelines and got importantly shorter after two interventions - strengthening the diagnostic team and specially by purchase of additional PET-CT machine (the average time from general practitioner (GP) referral to the multidisciplinary treatment board (MDTB) decision was 50.8 [± 3.0] prior and 37.1 [± 2.3] days after the interventions).
Conclusions
The study illuminated opportunities for refining the diagnostic journey for lung cancer patients, underscoring the importance of both administrative and capacity-related enhancements.
Ključne besede: lung cancer, diagnostic pathway, improvement
Objavljeno v DiRROS: 02.06.2025; Ogledov: 616; Prenosov: 794
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8. Endobronchial ultrasound elastography strain ratio for mediastinal lymph node diagnosisAleš Rozman, Mateja Marc-Malovrh, Katja Adamič, Tjaša Šubic, Viljem Kovač, Matjaž Fležar, 2015, izvirni znanstveni članek Ključne besede: cancer staging, elastography, endobronchial ultrasound, lung cancer, needle biopsy
Objavljeno v DiRROS: 23.04.2024; Ogledov: 1451; Prenosov: 754
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10. Priporočila za obravnavo bolnikov s pljučnim rakomMartina Vrankar, Nina Boc, Izidor Kern, Aleš Rozman, Karmen Stanič, Tomaž Štupnik, Mojca Unk, Maja Ebert Moltara, Vesna Zadnik, Katja Adamič, Jernej Benedik, Marko Bitenc, Jasna But-Hadžić, Anton Crnjac, Marina Čakš, Dominik Časar, Eva Ćirić, Tanja Čufer, Ana Demšar, Rok Devjak, Goran Gačevski, Marta Globočnik Kukovica, Kristina Gornik-Kramberger, Maja Ivanetič Pantar, Marija Ivanović, Urška Janžič, Staša Jelerčič, Veronika Kloboves-Prevodnik, Mile Kovačević, Luka Ležaič, Mateja Marc-Malovrh, Katja Mohorčič, Loredana Mrak, Igor Požek, Nina Turnšek, Bogdan Vidmar, Dušanka Vidovič, Gregor Vlačić, Ana Lina Vodušek, Rok Zbačnik, Ivana Žagar, 2023, strokovni članek Povzetek: Leta 2019 so bila objavljena Priporočila za obravnavo bolnikov s pljučnim rakom, ki so v slovenski prostor vnesla prepotrebno poenotenje diagnostike in zdravljenja z namenom izboljšanja preživetja bolnikov s pljučnim rakom. Posodobitev Priporočil tri leta po izidu izvirnika prinaša največ novosti v poglavju o sistemskem zdravljenju bolnikov s pljučnim rakom. To kaže na izjemen napredek na področju razumevanja onkogeneze in biologije pljučnega raka ter s tem razvoja novih zdravil. Breme pljučnega raka ostaja veliko, saj je pljučni rak pri nas in v svetu še vedno najpogostejši vzrok smrti zaradi raka. Za vsako peto smrt zaradi raka je odgovoren pljučni rak. Skoraj tretjina bolnikov s pljučnim rakom ne prejme specifičnega onkološkega zdravljenja, bodisi zaradi slabega stanja zmogljivosti, spremljajočih bolezni ali obsega bolezni. Polovica bolnikov ima ob diagnozi razsejano bolezen, zaradi česar izboljšanje preživetja z malimi koraki sledi napredku v zdravljenju bolnikov s pljučnim rakom. Ti podatki nas opominjajo, da se bomo morali za velike premike v obravnavi bolnikov s pljučnim rakom lotiti drugačnih pristopov. Kot najbolj obetavno se ponuja zgodnje odkrivanje bolezni, ko so možnosti ozdravitve pljučnega raka najboljše. Zapisana Priporočila so usmeritev za obravnavo bolnikov s pljučnim rakom. Le s sodobnim multidisciplinarnim pristopom obravnave lahko bolniku ponudimo zdravljenje, ki mu omogoča najboljši izhod prognostično neugodne bolezni.
Ključne besede: pljučni rak, priporočila
Objavljeno v DiRROS: 27.07.2023; Ogledov: 2276; Prenosov: 903
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