Iskanje po repozitoriju

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Povzetek: Background: Hepatitis C virus (HCV) infection remains a public health threat. Although therapy with direct-acting antivirals made its elimination possible, major challenges remain in treating vulnerable populations, such as people who inject drugs (PWID) enrolled in low-threshold programmes (LTPs). This study analysed the outcome of HCV management focused on HCV reinfection in a specifically designed model-of-care (MoC) for PWID in Slovenia, where treatment is prescribed without limitations, though only by specialist physicians. Methods: All HCV antibody (anti-HCV) positive users of a MoC, combining HCV management at Clinic for Infectious Diseases at the University Medical Centre in Ljubljana and LTP for PWID in 100 km distanced civil society organisation (CSO) Svit Koper, between January 2017 to December 2022, were included. The MoC enabled regular transportation of PWID between LTP and the Clinic, where specifically assigned services for individually tailored HCV management in cooperation with CSO were available. Data on participants´ demographic, epidemiological, and clinical characteristics were collected partly retrospectively and prospectively, with a particular focus on HCV treatment outcome and reinfection status, and analysed accordingly. Results: The study included 49 anti-HCV positive PWID with a mean age of 38.7 (standard deviation (SD) = 7.6) years at first visit. The majority was male (40/49, 81.6%); 16/49 (32.7%) experienced previous incarceration, 14/49 (28.6%) were experiencing homelessness, and 42/49 (85.7%) were receiving opioid agonist therapy. A total of 42/49 (83.7%) were HCV RNA-positive. Of them 36/42 (85.7%) started HCV treatment at a mean age of 42.7 (SD = 5.7) years and 33/36 (91.7%) completed treatment. Six (14.3%) HCV RNA-positive PWID died. Among 28/33 (84.9%) who achieved a sustained virological response 12 weeks post treatment, 6/28 (21.4%) presented with reinfection. The HCV reinfection rate was 13.3 per 100 - PY (95% confidence interval (CI) [6.0, 29.7]), the rate of positive HCV RNA re-test was 12.2 per 100 - PY (95%CI [7.7-16.7]), while hazard of reinfection in our cohort increased with time, with the estimated reinfection probability exceeding 0.5 at 4 years. Conclusions: In marginalised population of PWID attending LTP, a sustainable HCV RNA re-screening and follow-up after HCV cure are necessary, as the risk of reinfection remains high.
Ključne besede: hepatitis C, micro-elimination, people who inject drugs, low-treshold settings, reinfection, Slovenia
Objavljeno v DiRROS: 14.04.2026; Ogledov: 9; Prenosov: 6
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Povzetek: Background and aims Thyroid hormones regulate lipoprotein metabolism—primarily by up-regulating the LDL receptor. Whether TSH relates to LDL-C in hypercholesterolemic children, and whether this depends on familial hypercholesterolemia (FH) status or the underlying defective gene, is uncertain. We evaluated TSH–lipid associations in prepubertal children and tested effect modification by FH status and, within FH, by gene with a pathogenic variant (LDLR vs APOB). Methods We performed a cross-sectional study of prepubertal children referred to the Slovenian national tertiary center through the universal FH screening program or cascade screening. Eligibility required concurrent TSH and fasting lipid measurement and completed genetic testing (pathogenic/likely pathogenic variants in LDLR/APOB/PCSK9 vs polygenic hypercholesterolemia). Results Among 738 children, 182 (24.7%) were FH-positive (LDLR 132; APOB 50). In the pooled cohort, TSH did not correlate with age or lipids (all p≥0.050). After sex stratification, TSH correlated with triglycerides only in males (ρ=0.156; p=0.012). In FH-positive children, TSH correlated with total cholesterol, LDL-cholesterol, and ApoB (ρ≈0.184–0.207; all p<0.050), with no associations in FH-negative children. Interaction testing confirmed effect modification by FH (TSH×FH β=0.141 mmol/L per mIU/L, p=0.023). Within FH-positive children, a positive TSH–LDL-C slope was seen in LDLR carriers (β=0.237, p=0.004) but not in APOB carriers (β=−0.065, p=0.655). Conclusions TSH was positively associated with LDL-C only in FH due to LDLR variants, not in APOB carriers. These findings suggest that genetic background may shape hormonal sensitivity, and that attention to thyroid status could be particularly relevant in LDLR-FH.
Ključne besede: TSH, low-density lipoprotein cholesterol, familial hypercholesterolemia, LDLR, APOB, subclinical hypothyroidism
Objavljeno v DiRROS: 16.03.2026; Ogledov: 205; Prenosov: 130
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Povzetek: Cancer-associated thrombosis (CAT) is the second leading cause of death in cancer patients, significantly affecting their quality of life, survival, and health care costs. This review summarizes key recommendations from the 2023 European Society for Medical Oncology guidelines on CAT prevention and treatment, illustrated by a real-world case, and examines barriers to their implementation. CAT risk is multifactorial, shaped by tumor-related factors (type, stage, time since diagnosis), treatment exposures (anticancer agents, surgery, central venous catheters), and comorbidities, captured by the “4TS” rule. Emerging biomarkers (eg, D-dimer, thrombin generation, coagulome genes) and oncogenic mutations may refine risk stratification. The guidelines recommend routine assessment using models such as the Khorana score, COMPASS-CAT, or Vienna-CATS, with COMPASS-CAT demonstrating superior predictive accuracy for patients with breast, lung, ovarian, or colon cancer. For high-risk ambulatory patients, thromboprophylaxis is recommended for up to 6 months, with regular reassessment of risk thereafter. Treatment of CAT favors low-molecular-weight heparin or oral direct FXa inhibitors (apixaban, edoxaban, rivaroxaban), with incidental venous thromboembolism managed similarly to symptomatic events. The API-CAT study supports low-dose apixaban (2.5 mg twice a day) as a safer long-term treatment. Screening for antiphospholipid antibodies guides therapeutic strategies. Major challenges for optimization of the antithrombotic treatment include renal impairment, thrombocytopenia, and treatment adherence. Oral direct FXa inhibitors may improve quality of life. Effective CAT management requires individualized care, strong clinician–patient communication, and education. The guideline implementation remains suboptimal. Closing the gap demands national strategies promoting health-provider training, patient empowerment, e-health applications, equitable access, and dedicated CAT outpatient clinics for sustained, personalized care.
Ključne besede: cancer‑associated thrombosis, oral direct anticoagulants, guidelines, low‑molecular‑weight heparin, risk assessment model
Objavljeno v DiRROS: 24.02.2026; Ogledov: 271; Prenosov: 143
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Povzetek: We derive the far-field and near-field solutions for the Green’s function of a point force acting perpendicular to a no-slip wall in a Brinkman fluid, focusing on the regime where the distance between the force and the wall is much smaller than the screening length. The general solution is obtained in closed form up to a single integral, and can be systematically expanded in a Taylor series in both the far-field and near-field limits. The flow can then be expressed as a series of source-multipole singularities with an additional, analytically known, correction in the proximity of the wall. Comparisons with numerical integration demonstrate the accuracy and reliability of the asymptotic expansions. The results are also applicable to the unsteady Stokes flow driven by a localised assembly of forces, such as a beating cilium protruding from a flat surface.
Ključne besede: low-Reynolds-number flows, porous media
Objavljeno v DiRROS: 10.02.2026; Ogledov: 463; Prenosov: 125
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Povzetek: The impact of oxic and thermal transient phases on corrosion of carbon steel in cementitious environment was studied through three in situ experiments (Tournemire URL, France). For two years, heated metallic samples (80 °C) were placed in direct or indirect contact with two different cementitious materials: a low-pH Bentonitic Cement Grout (BCG) and a Portland cement paste material (CEM I). Mineralogical and microstructural analyses were carried out in an attempt to identify the combined effects of pH, chemistry and microstructure properties associated with such specific cementitious media on steel corrosion mechanisms. Additionally, in situ Electrical Resistance (ER) corrosion sensors allowed to continuously monitor the corrosion rates corresponding to each of the three field experiments. Post-mortem characterisation indicated that metallic samples embedded in low-pH BCG were heavily damaged and exhibited high corrosion rate. Conversely, steel samples in contact with highly alkaline CEM I environment appeared to be much less impacted by corrosion processes and revealed extremely low corrosion rate values. A comparison between these field experiments observations and results previously obtained through complementary laboratory mock-up tests finally enabled the evaluation of the impact that variations in geometrical/design aspect existing between in situ and laboratory tests can induce on material degradation.
Ključne besede: bentonitic cement-based grout, deep geological disposal of nuclear waste, anoxic environment, electrical resistance corrosion sensors, groundwater, low-pH cement
Objavljeno v DiRROS: 27.01.2026; Ogledov: 252; Prenosov: 80
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