1. Remission of chronic urticaria in patients treated with omalizumabKlara Cvenkel, Mojca Bizjak, Julij Šelb, Mitja Košnik, 2024, izvirni znanstveni članek Povzetek: Introduction: This study examined the remission probability and duration in chronic spontaneous urticaria (CSU) patients resistant to second-generation H1-antihistamines (sgAHs) undergoing omalizumab treatment.
Methods: This is a retrospective observational study of 176 adult CSU patients exhibiting a significant pruritus component (≥ 8) of the weekly urticaria activity score (UAS7) despite four daily sgAH tablets and starting omalizumab treatment with 300 mg every 4 weeks. After excluding 13 nonresponders, we analyzed 163 omalizumab responders (mean age 51.8 years, 74.4% female). The intervals between applications were increased. Discontinuation was considered for patients that remained asymptomatic on a gradually reduced dosage (to 150 mg every 12 weeks) without sgAHs.
Results: Omalizumab discontinuation was possible in 25.8% (42/163). The duration of omalizumab treatment before remission ranged from 7 to 6 months. Twenty-one patients (50.0%) maintained complete remission until the end of the observation period (September 2021) for 8 to 68 months. Of the relapsed patients, 71.4% (15/21) effectively controlled CSU with sgAHs. Six patients (28.6%; 6/21) required omalizumab reintroduction after 6 to 40 months of remission, responding favorably.
Conclusions: The study shows that a quarter of severe CSU patients achieve long-term remission. In addition, sgAHs effectively
manage symptoms in a majority of relapsed cases, and those requiring omalizumab reintroduction respond favorably.
Ključne besede: urticaria, antihistamines, omalizumab, urticaria, remission, urticaria relapse
Objavljeno v DiRROS: 16.06.2025; Ogledov: 15; Prenosov: 8
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2. 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: 136; Prenosov: 52
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3. 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: 121; Prenosov: 74
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4. Risk of anaphylaxis associated with cold urticariaMojca Bizjak, Krzysztof Rutkowski, Ricardo Assero, 2024, pregledni znanstveni članek Povzetek: 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.
Ključne besede: adrenaline (epinephrine), autoinjector, cold-induced anaphylaxis, cold urticaria, management, risk factors
Objavljeno v DiRROS: 28.05.2025; Ogledov: 123; Prenosov: 78
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5. Cold-induced anaphylaxis : new insights into clinical and genetic characteristicsMojca Bizjak, Peter Korošec, Mitja Košnik, Julij Šelb, Urška Bidovec, Manca Svetina, Samo Zver, Dejan Dinevski, Matija Rijavec, 2025, izvirni znanstveni članek Povzetek: The pathogenesis of cold urticaria (ColdU) and cold-induced anaphylaxis (ColdA) remains poorly understood, and ColdA is underrepresented in anaphylaxis literature. Laboratory features to guide management are largely unknown. This study evaluated basal serum tryptase (BST) and total immunoglobulin E (IgE) levels in ColdU and ColdA, their associations with clinical features, and the utility of testing for the KIT p.D816V variant in blood leukocytes and hereditary a-tryptasemia (HaT).
Ključne besede: anaphylaxis, cold urticaria, hereditary α-tryptasemia, KIT p.D816V, mast cell, total IgE, tryptase
Objavljeno v DiRROS: 21.05.2025; Ogledov: 208; Prenosov: 89
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7. Exploring beekeepers’ experiences and perceptions of anaphylaxis risks : a qualitative study to inform targeted health education programsTea Močnik, Sabina Ličen, Mihaela Zidarn, Mirko Prosen, 2024, izvirni znanstveni članek Povzetek: Background: Beekeeping plays crucial natural and economic roles but also poses health risks, as bee stings can cause severe allergic reactions like anaphylaxis, a potentially life-threatening condition that requires timely intervention. Understanding symptoms and the proper use of adrenaline autoinjectors is essential to minimize risks. This study aimed to assess the need for education on anaphylaxis and to develop a health education program to enhance beekeepers’ preparedness and safety. Methods: A qualitative descriptive interpretative method was employed. Two focus groups were conducted, one with eight health care professionals specializing in allergy and clinical immunology and the other with six active beekeepers. The data were analyzed via content analysis using QDA Miner® Lite v3.0.5 software. Results: The analysis structure comprises five thematic areas: (1) the management of anaphylaxis; (2) the prevention of anaphylaxis; (3) health education approaches; (4) systemic approaches in prevention; and (5) adrenaline autoinjectors. The results highlight key challenges, including the need for better strategies to manage anaphylaxis, improve prevention, and provide practical educational programs for beekeepers. There is also a need for better collaboration between health care professionals and beekeepers, as well as improved access to and knowledge of adrenaline autoinjectors. Conclusions: Targeted education for beekeepers on recognizing anaphylaxis symptoms and using adrenaline autoinjectors is essential for timely intervention and preventing severe outcomes. Given their exposure to bee stings, beekeepers require proper training and regular practice to improve preparedness and safety. This research underscores the need for a comprehensive educational program to reduce anaphylaxis risk and enhance safety in beekeeping.
Ključne besede: beekeepers, hypersensitivity reaction, epinephrine, exposure, awareness, prevention, health education
Objavljeno v DiRROS: 16.05.2025; Ogledov: 209; Prenosov: 115
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8. Paediatric cervicofacial lymphadenitis caused by non-tuberculous mycobacteria : nation-wide overview in the period 2000-2020Urška Šivic, Sara Truden, Špela Klemen, Marija Žolnir-Dovč, 2025, izvirni znanstveni članek Povzetek: Purpose
Cervicofacial lymphadenitis caused by non-tuberculous mycobacteria (NTM) is a rare but increasing infection in children worldwide. The purpose of this study was to analyse and evaluate all microbiologically proven cases of NTM lymphadenitis in children under the age 14 years in Slovenia.
Methods
Between 2000 and 2020, we retrospectively reviewed laboratory and medical records for basic demographic and microbiological data. Different clinical samples were collected in medical centres and regional hospitals from all over Slovenia.
Results
In the period before mandatory BCG vaccination was discontinued (2000–2005), we did not observe any case of paediatric NTM lymphadenitis. After discontinuation of non-selective BCG vaccination of new-borns (2006–2020), we identified 55 cases of microbiologically confirmed NTM lymphadenitis in BCG-unvaccinated children with median age 26.0 months (range: 15.0–75.0 months). Mean annual incidence of paediatric NTM lymphadenitis accounted for 1.26 (range: 0.35–2.38) per 100,000 children. The main causative agents were Mycobacterium avium (38/55; 69.1%) and M. intracellulare (9/55; 16.4%). We did not find any M. chimaera isolate. Since 2006, each year we microbiologically confirm sporadic cases of paediatric NTM lymphadenitis, a condition not diagnosed before.
Conclusions
After discontinuation of universal BCG vaccination in March 2005, first cases of paediatric NTM lymphadenitis appeared. Several possible reasons could be attributed to observed trend and further multinational observational studies are warranted to explore possible causal relationships.
Ključne besede: cervicofacial lymphadenitis, paediatric lymphadenitis, non-tuberculous mycobacteria, Mycobacterium avium, Mycobacterium intracellulare, mycobacterial lymphadenitis
Objavljeno v DiRROS: 18.04.2025; Ogledov: 373; Prenosov: 78
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9. CCL2/C–C chemokine receptor type 2‐mediated interactions among mast cells, basophils, and endothelial cellsMaruša Rihar, Rajia Bahri, Vida Forstnerič, Silvia Bulfone‐Paus, Peter Korošec, 2025, izvirni znanstveni članek Povzetek: Background IL-33 is involved in allergic processes by promoting the release of various mast cell (MC) chemokines, including CCL2. However, it is yet unclear which specific cell type is primarily responsible for producing CCL2 during acute allergic reactions. This study aims to investigate the role of IL-33 in promoting CCL2 production in mast cells and assess the effect of MC-derived CCL2 on basophil migration and endothelial permeability. Methods Human blood-derived MCs (hMCs) were generated from peripheral blood precursors, passively sensitized with IgE, treated with IL-33, and stimulated with anti-IgE. The concentrations of nine cytokines known to influence immune cell chemotaxis (CCL2, CCL5, CCL11, MIP-1α, IL-8, IL-10, IL-13, granulocyte-macrophage colony-stimulating factor (GM-CSF), and vascular endothelial growth factor (VEGF) were assessed in the supernatants of hMCs. Subsequently, we investigated the impact of MC-derived CCL2 on basophil migration in vitro, as well as its effect on endothelial monolayer permeability using human umbilical vein endothelial cells (HUVECs). Results Stimulation with anti-IgE induced a significant release of CCL2, GM-CSF, IL-8 and VEGF from hMCs. Additionally, incubation with IL-33 overnight increased the production of several cytokines. Mast cell-derived CCL2 not only enhanced basophil migration in vitro but also increased endothelial monolayer permeability in HUVECs. The effect was reversed by a C–C chemokine receptor type 2 (CCR2) antagonist, indicating the involvement of CCL2 signaling through the CCR2 receptor. Conclusions IL-33 induces the production of chemotactic cytokines in hMCs. Mast cell-derived CCL2 plays an important role in basophil chemotaxis in vitro and affects endothelial monolayer permeability in the HUVEC model.
Objavljeno v DiRROS: 27.03.2025; Ogledov: 344; Prenosov: 158
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10. Prospective observational study of COVID-19 vaccination in patients with thoracic malignancies : adverse events, breakthrough infections and survival outcomesUrška Janžič, Andrej Janžič, Abed Agbarya, Urška Bidovec, Katja Mohorčič, Marina Čakš, Peter Korošec, Matija Rijavec, Erik Škof, 2024, izvirni znanstveni članek Povzetek: Abstract: Due to the devastating COVID-19 pandemic, a preventive tool in the form of vaccination was introduced. Thoracic cancer patients had one of the highest rates of morbidity and mortality due to COVID-19 disease, but the lack of data about the safety and effectiveness of vaccines in this population triggered studies like ours to explore these parameters in a cancer population. Out of 98 patients with thoracic malignancies vaccinated per protocol, 60–75% experienced some adverse events (AE) after their first or second vaccination, most of them were mild and did not interfere with their daily activities. Out of 17 severe AEs reported, all but one were resolved shortly after vaccination. No significant differences were noted considering AE occurrence between different cancer therapies received after the first or second vaccination dose, p = 0.767 and p = 0.441, respectively. There were 37 breakthrough infections either after the first (1), second (13) or third (23) vaccine dose. One patient died as a direct consequence of COVID-19 infection and respiratory failure, and another after disease progression with simultaneous severe infection. Eight patients had moderate disease courses, received antiviral therapies and survived without consequences. Vaccination did not affect the time to disease progression or death from underlying cancer.
Ključne besede: thoracic malignancies, cancer therapy, COVID-19 vaccination, adverse events, breakthrough infection
Objavljeno v DiRROS: 24.03.2025; Ogledov: 282; Prenosov: 149
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