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1.
Treatment of uterine sarcomas at the Maribor University Clinical Centre between 1996 and 2011
Darja Arko, Andraž Dovnik, Iztok Takač, 2013, original scientific article

Abstract: Purpose: Uterine sarcomas are rare malignant tumours with a worse prognosis than endometrial carcinomas.This retrospective study was performed to determine the clinical and histologic characteristics, treatment, and outcomes in uterine sarcoma patients treated at our hospital over a 16-year period. Methods: Twenty-two patients (median age, 60.5 years) with uterine sarcomas were treated at our facility between 1996 and 2011. Information was collected from hospital and follow-up records and from the Cancer Registry of Slovenia. All tumours were classified according to the new FIGO classification for uterine sarcomas. Results: The majority of the patients presented with postmenopausal bleeding. The most common histologic subtype was leiomyosarcoma (50%), followed by carcinosarcoma (40.9%), and endometrial stromal sarcoma (9.1%). All of the patients were initially treated surgically, 21 by laparotomy and 1 laparoscopically. Eight patients were treated with postoperativeradiotherapy and 4 patients received postoperativechemotherapy. Disease progression was observed in 8 of17 patients who had sufficient followup information forthis analysis. The 5-year overall survival was 44 %.Conclusion: The overall survival of patients treated for uterine sarcomas in our study was comparatively good. Due to the small number and heterogeneity of the patients, larger multicentre trials are needed for a reliable analysis of factors influencing patient survival.
Keywords: maternični sarkom, histološke značilnosti, kirurško zdravljenje, dopolnilno zdravljenje, celokupno preživetje
Published in DKUM: 12.04.2024; Views: 112; Downloads: 5
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2.
Surgical treatment of acute patellar dislocation associated with bony avulsion in children
Samo K. Fokter, Andraž Dovnik, Nina Fokter Dovnik, 2013, original scientific article

Abstract: Purpose: The management of acute patellar dislocation in children and adolescents is controversial. Traditionally,most first time traumatic patellar dislocations have been treated nonoperatively. However, due to new knowledge about medial patellar stabilizers some authors have advocated for surgical repair. The present report describes the midterm subjective and functional results of operative treatment of acute patellar dislocation in children less than eighteen years of age with concomitant osteochondral fracture. Methods: Data on a cohort of sixteen patients (eight girls and eight boys) aged 14.9 years (mean, range12-17 years) with acute patellar dislocation were retrospectively collected. Intraarticular fragments were detected in all patients in conventional radiographs. Operative treatment consisted of arthroscopic removal (12cases) or refixation (4 cases) of the osteochondral fragments and direct repair of the damaged medial patellofemoral ligament (MPFL) if that was still feasible (13 cases). All patients were seen at six months, and a telephone interview with twelve patients (75%) was conductedat four years (mean, range 27 years). Results: Of the sixteen patients, two (12.5%) had a recurrent patellar luxation. The subjective IKDC score at the time of the most recent follow up was 86 (mean, range 63-100), and the Marx Activity Rating Scale score was 9.2 (mean, range 216).Conclusions: Direct surgical repair of the injured MPFLmay be considered an option to prevent subsequent dislocation and subluxation in first time traumatic dislocation of the patella in children and adolescents with osteochondral fractures and substantial disruption of medial patellar stabilizers.
Keywords: akutni izpah pogačice, patelofemoralna kostna avulzija, izpah pri otrocih, pediatrične poškodbe, kirurško zdravljenje
Published in DKUM: 12.04.2024; Views: 103; Downloads: 7
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3.
Cesarean scar pregnancy : case report and review of the literature
Andraž Dovnik, Polona Kores Testen, Lea Mlakar, Milan Reljič, Darja Arko, Iztok Takač, 2014, professional article

Keywords: zapleti po carskem rezu, nosečnost v brazgotini, vaginalni ultrazvok, histerotomija
Published in DKUM: 11.04.2024; Views: 152; Downloads: 1
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4.
Gastric cancer in pregnancy - diagnostic and therapeutic dilemma : case report
Lucija Kuder, Andraž Dovnik, Matjaž Horvat, Iztok Takač, 2016, professional article

Keywords: rak želodca, nosečnost, carski rez, gastrektomija, limfadenektomija
Published in DKUM: 11.04.2024; Views: 121; Downloads: 3
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5.
Early detection of neck lymph node metastases in breast cancer patients : the role of ultrasound and fine needle biopsy
Janez Rebol, Peter Balon, Peter Kokol, Boštjan Lanišnik, Iztok Takač, Andraž Dovnik, Nina Fokter Dovnik, Monika Sobočan, Darja Arko, 2019, original scientific article

Keywords: metastases, neck lymph, ultrasound, fine needle biopsy, breast canser
Published in DKUM: 27.03.2024; Views: 135; Downloads: 4
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6.
Contemporary approach to diagnostics in women with suspected pelvic endometriosis
Jure Knez, Andraž Dovnik, Maja Pakiž, Igor But, Milan Reljič, Vida Gavrić-Lovrec, Maja Banović, Iztok Takač, 2019, review article

Keywords: endometriosis, endometrioma, ovarian cysts, deep pelvic endometriosis, ultrasound, pelvic pain
Published in DKUM: 27.03.2024; Views: 187; Downloads: 7
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7.
Primerjava prednosti in slabosti takojšnje ter odložene prekinitve popkovnice pri novorojenčku
Tamara Serdinšek, Andraž Dovnik, Iztok Takač, 2015, review article

Abstract: Izhodišča: Prekinitev popkovnice pri novorojenčku je v porodništvu še vedno predmet raz- prav. Tako ločimo takojšnjo prekinitev popkovnice, ki se običajno izvede v prvih 10, 15, 30 ali celo 60 sekundah po rojstvu, in odloženo prekinitev popkovnice, ki običajno pomeni prekinitev popkovnice več kot 60 sekund ali 2–5 minut po rojstvu, ob prenehanju pulzacij popkovnice ali ob pojavu posteljice v porodnem kanalu. Takojšnja prekinitev popkovnice je ena od treh komponent aktivnega vodenja tretje porodne dobe, ki se je v modernem porodništvu uveljavilo v zadnjem stoletju, medtem ko je v nekaterih severnoevropskih državah ponekod v ZDA in Kanadi ter v razvijajočih se državah bolj aktualen fiziološki pristop. Zaključki: V zadnjih letih se takojšnja prekinitev popkovnice v številnih smernicah vse bolj zamenjuje z odloženo prekinitvijo, saj so raziskave potrdile številne prednosti slednje. Med najpomembnejšimi prednostmi odložene prekinitve popkovnice omenjajo višjo raven hemoglobina in feritina, večje zaloge železa, zmanjšano pojavnost anemije zaradi pomanjkanja železa, boljšo kardiopulmonalno prilagoditev in daljše trajanje zgodnjega dojenja pri donošenem novorojenčku ob nespremenjeni pojavnosti poporodne krvavitve pri materi. Prednosti odložene prekinitve popkovnice se kažejo tudi pri nedonošenčkih. Kljub vsemu je potrebna previdnost zaradi možnega pojava policitemije s hiperviskoznostjo, hiperbilirubinemije in dihalne stiske.
Keywords: prekinitev popkovnice, tretja porodna doba, anemija, pomanjkanje železa, poporodna krvavitev
Published in DKUM: 10.05.2017; Views: 1617; Downloads: 387
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8.
Incidence of positive peritoneal cytology in patients with endometrial carcinoma after hysteroscopy vs. dilatation and curettage
Andraž Dovnik, Bojana Crnobrnja, Branka Žegura Andrić, Iztok Takač, Maja Pakiž, 2017, original scientific article

Abstract: Background: The aim of the study was to compare the frequency of positive peritoneal washings in endometrial cancer patients after either hysteroscopy (HSC) or dilatation and curettage (D&C). Patients and methods: We performed a retrospective analysis of 227 patients who underwent either HSC (N = 144) or D&C (N = 83) and were diagnosed with endometrial carcinoma at the University Medical Centre Maribor between January 2008 and December 2014. The incidence of positive peritoneal cytology was evaluated in each group. Results: There was no overall difference in the incidence of positive peritoneal washings after HSC or D&C (HSC = 13.2%; D&C = 12.0%; p = 0.803). However, a detailed analysis of stage I disease revealed significantly higher rates of positive peritoneal washings in the HSC group (HSC = 12.8%; D&C = 3.4%; p = 0.046). Among these patients, there was no difference between both groups considering histologic type (chi-square = 0.059; p = 0.807), tumour differentiation (chi-square = 3.709; p = 0.156), the time between diagnosis and operation (t = 0.930; p = 0.357), and myometrial invasion (chi-square = 5.073; p = 0.079). Conclusions: Although the diagnostic procedure did not influence the overall incidence of positive peritoneal washings, HSC was associated with a significantly higher rate of positive peritoneal cytology in stage I endometrial carcinoma compared to D&C.
Keywords: endometrial carcinoma, peritoneal cytology, FIGO staging, hysteroscopy, dilatation and curettage
Published in DKUM: 10.05.2017; Views: 1109; Downloads: 347
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9.
Sezonska nihanja vitamina D pri nosečnicah in novorojenčkih v mariborski regiji
Andraž Dovnik, 2016, doctoral dissertation

Abstract: Izhodišča: Vitamin D je v maščobah topen vitamin, katerega pomanjkanje v nosečnosti povezujejo z različnimi zapleti v nosečnosti in boleznimi pri novorojenčku. V mariborski regiji še ni bilo raziskave, ki bi ugotavljala koncentracijo vitamina D pri nosečnicah in novorojenčkih. Namen raziskave je bil ugotoviti povprečne koncentracije vitamina D pri nosečnicah in novorojenčkih, pogostnost pomanjkanja vitamina D, dejavnike, ki vplivajo na koncentracjo vitamina D pri nosečnicah in novorojenčkih, in vpliv koncentracije vitamina D na pojav zapletov pri nosečnici in novorojenčku. Bolniki in metode: Opravili smo prospektivno opazovalno raziskavo na 400 nosečnicah in njihovih novorojenčkih v štirih različnih letnih časih. Izbrani meseci so bili na koncu vsakega izmed letnih časov. Mesec september je predstavljal poletno skupino, december jesensko, marec zimsko in junij pomladno skupino. V raziskavo smo vključili nosečnice kavkazijske rase, ki so živele na širšem področju Maribora in so podpisale osveščen pristanek. Iz anketnih vprašalnikov smo pridobili podatke o prehrani in izpostavljenosti soncu v nosečnosti. Iz zdravstvene dokumentacije smo pridobili podatke o zdravstvenem stanju nosečnice pred in med nosečnostjo, podatke o zapletih v nosečnosti in načinu poroda ter podatke o zdravstvenem stanju novorojenčka. Vzorec krvi nosečnice smo odvzeli tekom hospitalizacije, vendar ne kasneje kot dva dni po porodu. Odvzem vzorca krvi iz popkovnice smo opravili takoj po prekinitvi popkovnice po porodu. Koncentracije vitamina D smo razdelili glede na priporočila iz literature: > 80 nmol/L – zadostne koncentracije, 50‒80 nmol/L – nezadostne koncentracije, 25‒50 nmol/L – pomanjkanje in < 25 nmol/L – hudo pomanjkanje vitamina D. Rezultati: Povprečna koncentracija vitamina D pri nosečnicah v vseh štirih skupinah je bila 43,7 ± 23,8 nmol/L. 23,6 % nosečnic je imelo hudo pomanjkanje vitamina D, 41,5 % jih je imelo pomanjkanje vitamina D, 27,9 % jih je imelo nezadostne koncentracije vitamina D. Zadostne koncentracije vitamina D smo izmerili pri 7,0 % nosečnic. Povprečna koncentracija vitamina D pri novorojenčkih je bila 55,2 ± 30,9 nmol/L. Pri analizi vpliva posameznih dejavnikov na koncentracijo vitamina D pri nosečnicah so se kot pomembni pokazali letni čas (F = 33,979; p < 0,001), trajanje sončnega obsevanja 30 dni pred porodom (r = 0,371, p < 0,001), povprečna temperatura 30 dni pred porodom (r = 0,401, p < 0,001), uživanje rib (t = 2,183; p = 0,030), količina rib na obrok (F = 3,131; p = 0,026), uživanje prehranskih nadomestkov z dodanim vitaminom D (t = ‒4,271; p < 0,001), pogostnost sončenja (F = 3,144; p = 0,025) in trajanje ene epizode sončenja (F = 3,719; p = 0,012). Izmed omenjenih dejavnikov sta v multivariatni analizi statistično značilnost ohranila trajanje ene epizode sončenja (β = 0,185; p = 0,031) in jemanje prehranskih nadomestkov z dodanim vitaminom D (β = ‒0,098; p < 0,001). Nosečnice, ki so rodile prezgodaj (t = 2,296; p = 0,022), in tiste, ki so rodile s carskim rezom (t=2,053; p=0,041), so imele značilno nižje koncentracije vitamina D v primerjavi s kontrolami. Zaključki: Koncentracije vitamina D so bile pri veliki večini nosečnic v mariborski regiji nižje od priporočenih vrednosti. Paradoksalno so imeli novorojenčki višjo povprečno koncentracijo vitamina D kot nosečnice. V vseh štirih skupinah smo opažali močno pozitivno korelacijo med koncentracijami vitamina D pri materi in v popkovnični krvi. Med posameznimi letnimi časi smo ugotovili značilno razliko v koncentraciji vitamina D, pri čemer smo najvišje vrednosti ugotovili v junijski (pomladni) skupini, najnižje pa v marčevski (zimski)skupini. Koncentracija vitamina D je bila višja pri nosečnicah, ki so se v času nosečnosti več sončile, in pri tistih, ki so jemale prehranske nadomestke z vitaminom D.
Keywords: vitamin D, izid nosečnosti, stanje novorojenčka, prehranski dodatki, sončna svetloba, letni čas
Published in DKUM: 15.02.2017; Views: 2826; Downloads: 254
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10.
A prospective study of the correlation between infection of the uterine cervix and secondary bleeding after large loop excision of the transformation zone (LLETZ)
Darja Arko, Andraž Dovnik, Nina Fokter Dovnik, Iztok Takač, 2011, original scientific article

Abstract: Purpose: A prospective study was undertaken to evaluate the role of genital pathogens in postoperative bleeding necessitating secondary intervention after large loop excision of the transformation zone (LLETZ) of the uterine cervix. Methods: A total of 1419 patients with cervical intraepithelial neoplasia (CIN) who underwent LLETZ were included in the study. To determine the presence of genital pathogens, cervical swabs were collected before the procedure. Postoperatively, patients were followed up for bleeding necessitating secondary interventions. Results: Among 1419 patients, genital pathogens were present in 714 (50.3%) cases and absent in 705 (49.7%) cases. The most frequently isolated groups of microorganisms were group-B ß-haemolytic streptococci, alpha-haemolytic streptococci, Enterococcus sp. and coliforms. Secondary procedures due to severe bleeding were required in 48 (6.8 %) patients without and in 63 (8.8%) patients with genital pathogens, but this difference was not significant (chi-square test = 1.72; P>0.05). Conclusion: These data suggest that genital pathogens are very common in patients with CIN and are not an important cause of postoperative bleeding necessitating secondary intervention after LLETZ.
Keywords: cervikalna intraepitelijska neoplazija, genitalni patogeni, LLETZ, krvavitev, genitalna okužba
Published in DKUM: 10.07.2015; Views: 1601; Downloads: 66
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