Iskanje po repozitoriju

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Povzetek: Background: This study aimed to find an association between infants who had hyperglycemia and those who did not, those treated with insulin or not and several prenatal and postnatal variables or the suboptimal prescription of parenteral nutrition. Methods: We conducted a retrospective study, which included extremely premature infants (<28 weeks of gestation) admitted to the tertiary NICU, University Medical Centre Ljubljana, between 1 January 2021 and 31 December 2021. Blood glucose measurements, insulin treatment, general characteristics, nutritional data and complications of prematurity were obtained retrospectively from hospital data. Results: There were 21 infants included in the study who did not receive insulin and 17 who were treated with insulin. Infants receiving insulin were younger and lighter compared to the non-insulin treatment group (mean gestational age 178 vs. 188 days; median birth weight 680 g vs. 990 g). The younger insulin group of infants received the same daily number of total macronutrients per kg per day compared to the older non-insulin group, i.e., glucose, lipids and amino acids, as recommended for the gestational age and birth weight. After adjusting for gestational age, no significant association with complications of prematurity was found. Conclusions: The postulated explanation (with the prescription of a higher amount of macronutrients during the first seven days) for hyperglycemia and treatment with insulin in the less mature and lighter infants cannot be supported by the data given.
Ključne besede: hyperglycemia, extremely premature infants, nutritional intake, parenteral nutrition, complications of prematurity
Objavljeno v DiRROS: 06.08.2026; Ogledov: 116; Prenosov: 64
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Povzetek: Background The majority of children with primary immune thrombocytopenia (ITP) follow a benign, self-limiting course. However, early identification of children at risk for chronic disease, timely recognition of alternative diagnoses that may mimic ITP at onset, and selection of patients for observation alone remain important clinical challenges. Methods This retrospective single-center study included patients aged ≤18 years who were evaluated for ITP between 2009 and 2024. Demographic, clinical, laboratory, and therapeutic data were collected at diagnosis and during follow-up. Factors associated with chronic ITP were assessed using logistic regression, providing odds ratios with 95% confidence intervals. Kaplan-Meier analysis was used to describe time to first bleeding complication according to initial management. Results A total of 271 patients were included (43.5% female; median age 4 years). Of these, 240 were ultimately diagnosed with ITP, while 31 received an alternative final diagnosis. In multivariate logistic regression, chronic ITP was independently associated with older age (OR 1.08; p=0.017), absence of a preceding infection or vaccination (OR 0.45; p=0.029), and higher platelet count at diagnosis (OR 1.03, p<0.0001). Compared with patients with final ITP, those with alternative causes of thrombocytopenia were older (p=0.034), had lower bleeding grades (p=0.037), higher MCV, and lower total leukocyte, lymphocyte, monocyte, and eosinophil counts at onset (all p<0.05). Patients receiving upfront pharmacological therapy were younger and presented with higher bleeding grades and lower platelet counts than those managed with observation. Bleeding complications were more frequent with upfront pharmacological therapy, whereas those in the watch-and-wait group tended to be more severe. Conclusion Our results suggest that readily available data may help identify children at risk for chronic disease and those whose thrombocytopenia is attributable to a cause other than ITP. Initial treatment decisions appeared to be driven primarily by clinical presentation.
Ključne besede: Alternative diagnoses, chronicity, complications, immune thrombocytopenia, pediatrics, watch- and-wait management
Objavljeno v DiRROS: 23.07.2026; Ogledov: 191; Prenosov: 108
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Povzetek: Background/Objectives: Robot-assisted partial nephrectomy (RAPN) has increasingly replaced laparoscopic partial nephrectomy (LPN) in the management of localized renal tumours. This study aimed to evaluate perioperative, functional and surgical margin outcomes during an institutional transition from LPN to RAPN in a high-volume centre. Methods: We performed a retrospective single-centre analysis of 100 consecutive patients undergoing minimally invasive partial nephrectomy. The last 50 LPN cases (August 2014– May 2018) were compared with the rst 50 RAPN cases (June 2018–February 2020). Baseline characteristics, perioperative outcomes, early functional parameters and surgical margin status were analysed. Complications were classied according to the Clavien– Dindo system. Results: Tumours treated in the RAPN group were signicantly larger (3.4 vs. 2.5 cm) and more complex (RENAL score of 6 vs. 5; p < 0.001). Operative time was longer in the RAPN group (143 vs. 122 min; p < 0.01), while warm ischaemia time did not di er signicantly (16 vs. 15 min; p = 0.37). Estimated blood loss was lower (0 vs. 10 mL; p = 0.049) and the hospital stay was shorter (3 vs. 4 days; p < 0.001) in the RAPN group. Haemoglobin decrease and postoperative creatinine change were comparable between groups. Positive surgical margins were observed less frequently in the RAPN group (2.3% vs. 7.7%), but this di erence was not statistically signicant (p = 0.34). Complication rates were signicantly lower in the RAPN group (4% vs. 22%; p < 0.05), with no major complications observed in the robotic cohort. Conclusions: In this institutional experience, RAPN was associated with favourable perioperative outcomes during the transition period, despite the treatment of larger and more complex renal tumours. The slightly longer operative and warm ischaemia times likely reect a more comprehensive reconstruction strategy, which may contribute to improved haemostatic control and lower complication rates. Further studies with extended follow-up are required to evaluate oncological and renal functional outcomes.
Ključne besede: robot-assisted partial nephrectomy, laparoscopic partial nephrectomy, renal cell carcinoma, nephron-sparing surgery, minimally invasive surgery, warm ischaemia time, surgical outcomes, complications, renal function, enucleation
Objavljeno v DiRROS: 01.07.2026; Ogledov: 215; Prenosov: 141
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Povzetek: BACKGROUND: Goal-directed fluid therapy (GDFT) with hemodynamic monitoring may not be of benefit to all elective patients undergoing major abdominal surgery, particularly those managed in enhanced recovery after surgery protocols (ERAS) setting. AIMS: We predicted different fluid and vasoactive drug consumption during the procedure and less complications in the group of patients, where invasive hemodynamic monitoring was used. METHODS: Two groups of patients undergoing elective laparoscopic colorectal surgery were compared: A control group (CG), with standard hemodynamic monitoring, and a study group, (SG) with invasive hemodynamic monitoring and appropriate intraoperative interventions. We compared differences in intraoperative fluid consumption, length of hospital stay (LOS) and post-operative morbidity. RESULTS: A group of 29 patients in SG had similar average intraoperative fluid balance (+438 mL) as 27 patients in CG (+345 mL) p = 0.432. Average LOS was 8 days (±4) in SG and 6 days (±1) in CG (p = 0.124). Acute renal failure, anastomotic dehiscence, and indication for antibiotic treatment were predictors of statistically significant prolongation of hospital stay 3rd day after surgery, but independent of SG. CONCLUSION: Since no differences between the groups were shown in overall fluid and vasoactive drug consumption, we conclude that GDFT is not needed in laparoscopic colorectal surgery, when ERAS is followed.
Ključne besede: laparoscopic abdominal surgery, Hemodynamic monitoring, post-operative complications
Objavljeno v DiRROS: 15.06.2026; Ogledov: 245; Prenosov: 153
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Ključne besede: liver transplant, simultaneous organ transplantation, transplant outcomes, postoperative complications
Objavljeno v DiRROS: 12.06.2026; Ogledov: 199; Prenosov: 150
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