Iskanje po repozitoriju

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Povzetek: Introduction: Osteoporosis is a common metabolic bone disease that increases fracture risk, particularly among older adults, and imposes a substantial global burden. Despite advances in risk assessment and treatment, a large treatment gap remains, with many high-risk individuals not receiving care. Methods: We conducted a systematic review of English-language studies published up to April 2025, identified through searches in multiple databases (PubMed, Scopus, Web of Science, ScienceDirect, Europe PMC). 43 studies were included. Due to the heterogeneity of study designs and treatment gap definitions, a narrative thematic synthesis was performed. Results: Reported treatment gap estimates varied widely (38.8–94.6%) across countries and study populations. Lower treatment rates were associated with patient factors (male sex, lower socio-economic status, comorbidities) and healthcare system factors (limited physician awareness, institutional barriers, poor interprofessional communication). Higher treatment rates were associated with older age, family history of osteoporosis, prior diagnosis or bone mineral density testing, and participation in structured care programmes. Conclusions: Substantial global treatment gaps in osteoporosis care persist, particularly following fragility fractures. These gaps arise from multiple patient, physician, and system-level factors, with persistent disparities by sex, ethnicity, comorbidities, and socio-economic status. Findings highlight the need for standardised definitions of the treatment gap and suggest areas for future research and intervention development.
Ključne besede: osteoporosis, fragility fractures, healthcare disparities, treatment gap, care gap
Objavljeno v DiRROS: 04.09.2026; Ogledov: 48; Prenosov: 26
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Povzetek: Objectives: This study aimed to explore whether the type of iron preparation used to treat postpartum anaemia affects the incidence of postpartum depression and whether the risk of postpartum depression is higher in postpartum patients with anaemia who were adequately treated compared to the general postpartum population. Study design: Single-center, open-label, randomized trial. Women were allocated to receive intravenous ferric carboxymaltose, intravenous ferric derisomaltose or oral ferrous sulphate. Intravenous iron was given in one or two doses, while ferrous sulphate as two 80 mg tablets once daily. Primary outcome was postpartum depression measured by Edinburgh Postnatal Depression Scale (EPDS) six weeks postpartum. Haematological parameters were analyzed as secondary outcomes. Kruskal-Wallis test was used for group comparison (p < 0.05 significant). The chi-square test was applied to compare categorical variables as well as the group of all subjects treated for anaemia in the study with the historical data for the Slovenian postpartum population. Results: Three-hundred women with postpartum anemia (hemoglobin < 100 g/L within 48-hours postpartum) were included between September 2020 and March 2022 in tertiary perinatal center. Most characteristics were similar across groups. EPDS score at six weeks postpartum did not differ between groups. The treatment modality of postpartum anaemia did not have a statistically significant effect on the EPDS score six weeks after treatment (p = 0.10), nor did it have a statistically significant effect on the difference in EPDS scores before and after treatment (p = 0.68). The proportions of participants who scored 10 or more points on the EPDS scores at six weeks postpartum were not statistically different between the groups (p = 0.79). The proportion of participants with an EPDS score of 10 or more at six weeks postpartum in the total study population did not differ significantly from previously reported proportion of postpartum women with EPDS score of 10 or more in the general population (12 % vs. 21 %; p < 0.001). Conclusions: Maternal depression at 6 weeks postpartum did not differ in women treated for postpartum anemia with intravenous ferric carboxymaltose, intravenous ferric derisomaltose or oral ferrous sulphate. Participants with postpartum anaemia who are adequately treated with either oral or intravenous iron preparations are not at a higher risk of postpartum depression than the general population at six weeks postpartum.
Ključne besede: postpartum anemia, postpartum depression, intravenous iron treatment, oral iron treatment, patient oriented outcome
Objavljeno v DiRROS: 31.08.2026; Ogledov: 70; Prenosov: 40
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Povzetek: Anti-amyloid treatment (AAT) with monoclonal antibodies represents a major therapeutic advance in early Alzheimer disease (AD), but its introduction has important and underappreciated implications for vascular neurology. Because many patients with AD also have cerebral amyloid angiopathy and other cerebrovascular pathology, AAT influences stroke diagnosis, acute reperfusion therapy, and long-term antithrombotic management. Clinical trials of lecanemab and donanemab enrolled highly selected patients with minimal baseline cerebrovascular pathology, limiting generalizability to real-world populations with prevalent vascular comorbidity. Amyloid-related imaging abnormalities, particularly vasogenic edema and microhemorrhages, constitute a central safety concern and may clinically mimic acute ischemic stroke, complicating emergency decision-making and increasing the risk of inappropriate intravenous thrombolysis (IVT). Emerging reports of intracerebral hemorrhage following IVT in treated patients underscore the need for revised acute stroke pathways and support consideration of mechanical thrombectomy when otherwise indicated, although AAT-specific safety data are lacking. Beyond the hyperacute phase of stroke, concomitant use of anticoagulants or dual antiplatelet therapy raises unresolved questions regarding hemorrhagic risk, particularly in patients with atrial fibrillation or those requiring complex antithrombotic regimens. Alternative strategies, including left atrial appendage closure, may be considered in selected patients, although evidence in AAT recipients remains limited. As AAT enters routine practice, multidisciplinary collaboration, dedicated imaging protocols, and prospective safety registries will be essential to integrate disease-modifying AD treatment with safe and effective cerebrovascular care.
Ključne besede: anti-amyloid treatment, ARIA, cerebrovascular disease, multidisciplinary, stroke management
Objavljeno v DiRROS: 20.08.2026; Ogledov: 169; Prenosov: 112
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Ključne besede: gaseous plasma treatment, hydrothermal treatment, biocompatibility, vascular stent, nanostructured surface
Objavljeno v DiRROS: 03.08.2026; Ogledov: 217; Prenosov: 188
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Povzetek: Background: The transition from the parenteral to subcutaneous application of systemic oncological therapy represents one of the most important innovations in modern oncology, as it affects the quality of life of patients as well as the organization of work and the management of health services. The introduction of this change requires effective leadership, interdisciplinary cooperation, and the adaptation of existing processes in healthcare organizations. Methods: We conducted a systematic review of the professional and scientific literature, considering the purpose and goal of this research. We used electronic databases: Wiley Online Library, PubMed, COBBIS.SI, and Google Scholar web browser. Papers from 2017 to 2025 were considered and processed using meta-synthesis. Results: Recent studies confirm that the subcutaneous administration of immunotherapy and targeted therapy is as effective and safe as parenteral immunotherapy, while significantly reducing treatment time and improving patient experience. Discussion: The transition to subcutaneous application provides an opportunity to transform oncology care. From a management perspective, the introduction of subcutaneous application requires systematic change management, staff training, process adaptation, and interdisciplinary cooperation. The sustainable implementation of innovations depends on organization, communication, and management support.
Ključne besede: lung cancer, oncological therapy, quality of medical treatment
Objavljeno v DiRROS: 30.06.2026; Ogledov: 218; Prenosov: 99
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